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Our Values in Action Annual Review 2007

“What struck me most about Medair was that it stayed during the war, when other health centres and NGOs either closed or left the country. Because Medair stayed and continued to act, despite all the violence and danger, it is the most respected organisation in the entire region.� Alphonsine Unwang, joint co-ordinator of SYNERGIE (D.R. Congo NGO)

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MEDAIR Annual Review 2007

Congolese families on the move.

Table of Contents Map of Medair country programmes

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Programme summary chart

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Letter from Randall Zindler, CEO

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Medair Values

6–9

Core Competency – Emergency Relief

10

Core Competency – Rehabilitation

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Sector of Expertise – Health Services

12 – 13

Sector of Expertise – Water and Sanitation

14 – 15

Sector of Expertise – Shelter and Infrastructure

16 – 17

Country Programmes

18 – 35

Behind the Scenes

36 – 38

The Value of People

39

Making a Lasting Difference

40

Funding Partners

41

Accreditations

42

Impressum

43

Medair brings life-saving relief and rehabilitation in disasters, conflict areas, and other crises by working alongside the most vulnerable. 3

AFGHANISTAN • PAKISTAN •

SUDAN • (Northern States)

• SOUTHERN SUDAN • UGANDA

INDONESIA •

D.R. CONGO •

• MADAGASCAR

2007 Medair Summary • 2,313,317 Total Beneficiaries • 8 Country Programmes • 7 Countries of Operation • 1 International Headquarters in Switzerland, 53 positions • 5 Affiliate Offices in France, Germany, the Netherlands, U.K., and USA • 119 Internationally Recruited Staff positions in the field • 979 Nationally Recruited Staff

Countries

Crises

Afghanistan

Conflict

• Post-conflict recovery (in areas where Medair works)

Natural disaster

• Earthquakes • Drought

Other crises

• High general population vulnerability • Disease epidemics • Food crises

D.R. Congo

Challenges

Conflict

• Sporadic ongoing conflict • Post-conflict recovery

Other crises

• High general population vulnerability • Disease epidemics

Countries

Crises

Southern Sudan

Conflict

• Sporadic ongoing conflict • Post-conflict recovery • Significant IDP population

Natural disaster

• Flooding • Drought

Other crises

• High general population vulnerability • Disease epidemics • Food crises

Conflict

• Ongoing conflict • Post-conflict recovery • Significant IDP population

Natural disaster

• Flooding • Drought

Other crises

• High general population vulnerability • Disease epidemics • Food crises

Conflict

• Sporadic ongoing conflict • Post-conflict recovery • Significant IDP population

Sudan (Northern States)

Challenges

Indonesia

Natural disaster

• Tsunami • Earthquakes • Volcano

Madagascar

Natural disaster

• Cyclones • Flooding

Other crises

• High general population vulnerability • Food crises

Natural disaster

• Flooding • Drought

Natural disaster

• Earthquake

Other crises

Other crises

• High general population vulnerability

• High general population vulnerability • Disease epidemics • Food crises

Pakistan

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MEDAIR Annual Review 2007

Uganda

Letter from Randall Zindler, CEO Every year, Medair brings life-saving relief and rehabilitation to more than two million people. We cultivate relationships of mutual respect with our stakeholders, including NGOs, governments, and our beneficiaries. Our quality standards are high, and major and private donors are expanding their support. Furthermore, our staff often comment on our remarkable team spirit, particularly given our diverse cultural, racial, and linguistic backgrounds. So what makes Medair a special organisation? How are we able to achieve significant results year after year, earning the respect and support of others, and maintaining a committed and passionate team?

From emergency relief responses that saved lives in Madagascar and Southern Sudan, to longer-term rehabilitation that helped people recover with dignity in Uganda, Afghanistan, and Indonesia, these pages offer a revealing window into our activities and our impact on the most vulnerable.

You will meet Safia Jabeen, a young woman widowed by the Pakistan earthquake, who is now rebuilding her life and livelihood with help from a Medair sewing-training programme. You will read about midwife Ruth Mutanga in conflict-scarred D.R. Congo, who used her own small home as a maternity clinic until this year, when Medair constructed a proper building. Or Awad Abbas in Sudan’s Southern Kordofan region, who received training to construct bio-sand filters for his village as part of an ongoing “What makes Medair initiative to facilitate safe and Medair a special sustainable water supply in his country. organisation?”

In 2007, these questions served as inspiration for an organisation-wide process that sought Randall Zindler to clarify and define Medair’s identity and What makes Medair a special organisation? values. From our Swiss headquarters to our On their own, our values are inspirational most remote field sites, we conducted extensive consultations ideals, while our actions, on their own, provide real support about who we are, what we do, and how we are able to do it. to the vulnerable. However, it is the combination of our And from this process, six distinct values emerged consistently values in action that makes us a truly special organisation, and with great clarity: enabling us to have a profound impact on the lives of our staff and the lives of the people we faithfully serve. Hope. Compassion. Dignity. Accountability. Integrity. Faith. These are the Medair Values, the ways our staff strive to live and work every day, in times of peace and in times of conflict. They are the foundation for everything we do, and the motivation for everything we aim to be. Our consultative process paid solid dividends for us this year, resulting in a reinforced understanding of the Medair identity. It was a high-impact year for us throughout the organisation. Our activities directly affected millions of people, not just with life-saving aid but also with increased capacity for self-sufficiency. The 2007 Medair Annual Review is richly informed by our rearticulated identity, integrated within a collection of compelling stories, photographs, and features from our eight country programmes.

Randall and Pakistani residents celebrate the opening of a Medair-built school.

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“Staff right across Medair were involved in the recent organisational values review. Having completed that process, it is exciting to hear, time and again, how passionate Medair staff are to live these values, as they pursue numerous activities throughout the organisation.� Jonathan Tame, Founding Medair Board Member

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MEDAIR Annual Review 2007

Health education in Pakistan.

Accountability Compassion

Hope Faith

Dignity Integrity

Medair Values

Accountability We are committed to employ best practices in our management and operations, pursuing excellence in all we do. We make ourselves accountable to our supporters, our staff, and those we serve, and seek input from them to help us improve our activities and procedures. “After 10 years of professional experience in the fields of fiduciary, trading, venture capital, and fund accounting, I began working for Medair in February 2007. What has struck me the most in almost a year’s time is that they really do what they say and believe in! Honestly, working in a blurry area such as finance, things can be often twisted around according to the big bosses’ own interests.

threatened by audits or new regulations, we welcome them as a way of improvement. Such a challenge requires efforts and strategies that apply to all our staff worldwide. I am fulfilled to work in an environment that provides me with such deep meanings of accountability.”

At Medair, providing transparent and accurate accounting is not just a value, it is put into action. Instead of feeling

Francine Kohli, Swiss Certified Specialist for Finance and Accounting, International Headquarterseadquarte

Compassion We desire to relieve human suffering in times of crisis, disaster, and conflict. We seek out people who are the most vulnerable, come alongside them and offer practical support through relief and rehabilitation initiatives. “After years of working in D.R. Congo, I feared that by moving to work at the international headquarters in Switzerland, I would not experience the depth of commitment I had found in the field. But I have indeed witnessed Medair’s values here as much as in the field. One day we were informed that one of Medair’s nationally recruited staff in Kampala, a Ugandan woman named Bea, had a health problem that required a surgical intervention. The price of the operation was very expensive for her. At the headquarters, we were informed of her situation and invited to freely contribute if we felt so led. I knew Bea personally from passing through Kampala many times, so I was naturally moved to make a donation. But I

was truly touched when I heard the quite important amount that was raised for her at our headquarters. To think that many colleagues who had never been to Uganda gave significantly for Bea showed me how much they personally care about what is going on in the field. And it is not rare that we spend time together praying for individual beneficiaries or our staff’s needs. In this way, we live out the value of compassion, understood not solely as compassion toward disaster-affected people, but inclusive compassion toward our neighbour.” Donata Schneider, Desk Officer, D.R. Congo

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Dignity We believe that each person has been made in God’s image and is therefore uniquely valuable and worthy of the highest respect. Consequently, we reach out to all those in need, irrespective of their race, gender, religion, age, or nationality. Wherever possible we personalise our assistance, taking individual needs and circumstances into account, and respecting the dignity and independence of the people we serve. “The heart of a Medair intervention is partnership. We are not in Madagascar just to implement our projects or build water points for the local population. Instead, we are here to work alongside communities to help them to improve their living conditions with dignity.

With the Rano Tsara (Good Water) Project, our partnership is based on mutual respect and mutual sharing of knowledge. Decisions are made at the community level only after extensive consultations with the local population, ensuring that individual needs are heard and taken into consideration. This approach promotes self-esteem and acknowledges the innate dignity of every person we serve.” Christophe Roduit, Medair Country Director, Madagascar

Hope We seek to bring hope to people devastated by crisis and caught in apparently hopeless situations. Together with the communities we serve, we strive to make sustainable improvements and increase their capacity to build a better future. “When I worked with Medair in northern Uganda, sometimes I would play football with former child soldiers, and would delight in seeing them play like regular children. Often, I would hear them say, ‘It’s as if, when I play football, I forget all the trouble.’ These conflict-affected children now have the chance to integrate back into their communities. However, they need help developing their self-confidence, to really believe that they can live normal lives. One former child combatant needed to rely on his neighbours for everything. He had no money to attend school, and very little hope. I started encouraging him to think about how he could solve his problem, and soon he came up with ideas for 8

MEDAIR Annual Review 2007

selling cement in the market. Eventually, he made enough money to go to school. It was so nice to see him having hope. But one or two times, he was very down and came to me. He would start to cry and say all the things he had done – he’s still so ashamed. I said, ‘But it’s done now, you are a good man now, you are not a killer.’ With Medair’s programmes and the personal touch of our staff, we are trying to help these vulnerable young people get back to living a more normal life. And the greatest thing we can build in them is hope; the hope that they can be like every other child in the world.” Michael Wurzner, former Medair Logistics Manager, Uganda

Accountability Compassion

Hope Faith

Dignity Integrity

Medair Values

Faith We are motivated to care for those who suffer because we follow Jesus Christ, who taught that our highest goal is to love God and to care for those in need. Our faith inspires us to give our best in all circumstances. By faith we pray for wisdom when facing difficult decisions, and for courage to live and work in demanding and often dangerous situations. “Someone was needed to fill the project coordinator’s position for a few weeks. Since I was based in Khartoum, I was one of the options. A huge project in an unstable and complex political situation, one could hope for a better holiday destination! Besides, I wasn’t confident I could measure up to the task. However, I trusted God. And I went, with my heart at peace. I knew I was in the right place, even though the security situation deteriorated. Even when hearing shooting became the norm, even when scary green camouflage helicopters turned over our heads, even when civilians were killed, even when a few bombs dropped some kilometres away, even when rebels moved closer every day...

Even then, I had peace in my heart despite the tiredness creeping in, despite my to-do list getting longer and longer, while the world continued to turn, unbothered by these active machine guns in West Darfur. We knew we were in the right place, as prayers never stopped within the teams in the field, in Khartoum, or at headquarters. My faith did not stop just because I didn’t and still don’t have answers on violence and suffering. My faith increased and continues to feed my determination to respond to the suffering. There I have learned that I don’t need to have all the answers, I just choose to be there, and choose to act... in faith.” Fabienne Laurenzio, Medical Coordinator, Sudan (Northern States)

Integrity We strive to live out our values and principles consistently at every level of the organisation, and in every location – from the remotest team to the international headquarters. Our desire is that as we work together in teams, our attitudes, words, and actions will be true to Medair’s vision and character. “All the people of the districts that are covered by Medair are very happy. For example, it is clear from all kinds of meetings that there is nothing against Medair, and it has the best reputation among the people because of the health services for the needy people. One other good point is that Medair always wants to work in the rural areas, and for the most needy people.” Najibullah, Nationally Recruited Medair Finance/Admin Officer, Afghanistan

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Emergency Relief When a sudden crisis hits or a natural disaster strikes, Medair responds rapidly and effectively to help save lives and reduce suffering. Rising Above the Waters In August, severe flooding in Southern Sudan destroyed homes and displaced thousands of people, with the high waters making it very difficult to reach the most affected people. Medair and Tearfund staff trekked for over 40 kilometres through thick mud and snake-infested swamps to reach the surprised residents of Oriny, who had been hit

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MEDAIR Annual Review 2007

hard by the floods. The team assessed the population’s urgent needs, and 10 days later, three planes full of emergency provisions were able to land safely in Oriny, providing vital support to the community in their time of need. Photos, top: Sudanese women walking through the floodwaters. bottom: Medair staff in flooded area.

Core Competencies

Rehabilitation Once emergency relief needs are met, Medair works alongside vulnerable communities to help restore services and livelihoods to a pre-existing or slightly improved level. We focus on increasing the capacity of the local community to respond to future crises.

Photos, from top to bottom:

Measuring distance, elevation, and slope from the village to the water source. Community members digging the 1.4 km long trench for the pipes. A hand-washing facility, part of the village water distribution system.

A Village Water Supply In July, Medair partnered with the community of Malamavato in Madagascar to establish a gravity-fed water supply system to provide its 700 residents with safe water directly in the village. The source of their water supply was located 1.4 kilometres away, so success depended on dedicated efforts from the whole village as well as from our Medair staff. The water supply was tapped and protected, 12 metric tonnes of building material were carried in on a two-hour footpath, trenches were dug for the plastic piping, and sand, gravel, and stones were collected for the construction sites. The project was completed in October, and now provides safe water right in the village, for a capacity of over 1,000 people. This community-based rehabilitation project was designed to improve health and quality of life for residents, but it also served to strengthen community relationships, as everyone worked together, taking ownership of their long-lasting achievement. 11

Health Services We have been delivering and supporting Health Services since our inception close to 20 years ago. Over that time, we have gained invaluable experience and are now significantly involved in improving the quality and sustainability of health care in remote and insecure areas around the globe. While natural disasters and conflicts cause significant injuries, the most serious health threats come from common illnesses and disease outbreaks that occur in the aftermath of crises. Health risks are multiplied when these threats occur in areas that lack access to basic health services. Our priority is to provide primary health care, with particular emphasis on the prevention and treatment of infectious diseases, and to increase the capacities of local health workers and facilities. We ensure greater access to improvedquality health care that also has an increased level of sustainability. We maintain a flexible approach, providing emergency responses and more specialised health care as well, when needed. 12

MEDAIR Annual Review 2007

Health-Related Need

Medair Action

Illness and infectious disease

Curative • Primary health care clinics • Disease control • Referral to hospitals Preventative • Mosquito net distributions (malaria prevention) • Vaccination campaigns • Health and hygiene promotion

Sudden outbreaks of infectious disease

• Emergency responses • Curative and preventative activities

Maternal health problems

• Reproductive health and safe motherhood activities • Antenatal clinics

Conflict-affected women and children

• Psychosocial support in displaced person camps and for specific target groups (including men) • Care for victims of sexual violence

Malnutrition

• Nutritional support • Food distribution • Distribution of seeds

Quality and sustainability of health care in a region

• Capacity building and support to the basic health care system • Support for local health structures and staff • Supervision and monitoring of clinics and staff • Training of health staff • Health Information System management and support • Surveys, assessments, field studies, and operational research

Sectors of Expertise

New Day in Melut Town Medair’s Health Services sector provides primary health care in Southern Sudan. The biggest challenge facing Medair’s new Primary Health Care Centre (PHCC) in Melut Town may be its enormous popularity. “People are so happy,” said Paul Akoch, a Medair-trained Community Health Worker (CHW). “The news travels fast and more and more people are coming from afar to receive treatment.”

Great Need in Melut for Proper Health Care “At first, the people were really suffering in Melut County,” said Paul. “They had to see doctors who had no facilities, and had to go to the market to buy the prescribed medicines. But they would never really know if the medication was right or not, and a lot of people died as a result of no proper health care.” Early in 2007, Paul and the Medair team set up a temporary PHCC in tents that did not provide much protection from the elements. Meanwhile, construction began on a new permanent PHCC, which opened in November. “Not only is there now a proper and impressive building standing out in the vast lands on the outskirts of Melut,” said Wendy van Amerongen, Medair Communications Manager, “but you can also see order, hygiene, and systems in place to bring effective cure and comfort to vulnerable patients.”

Many Patients for the New PHCC On a recent visit to the new facility, Wendy met a young boy named Ayuel Joseph Manyeut. He was being discharged after five days of treatment for pneumonia and trauma to his body. The wounds had been accidentally inflicted when his brother tried to carry the short-of-breath boy home to his mother and accidentally dropped him. Unable to get him the necessary treatment closer to their home, Ayuel’s family brought him by boat to Melut, where he received the right medication and close monitoring on a clean bed. “The work is easier now,” said David Akol Deng, a Medair Medical Assistant. “The only problem is that there are too many patients to be seen.” Every morning, 100 patients are already waiting by the time the centre opens. According to David, it is not just the proper building, good hygiene, and excellent staff that attract people. “It’s also because Medair is working compassionately and taking the time to hear every individual’s story. That’s why more and more people are coming.” Photos, left: Medair nurse with Sudanese newborn. right: Medair medical assistant examines small boy.

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Water & Sanitation In the past 15 years, Medair’s Water and Sanitation (WatSan) expertise has grown substantially, providing vital and lasting support for the world’s most vulnerable. Today, over one billion people have no access to safe drinking water. Even more people lack access to adequate sanitation (2.6 billion). In the absence of safe water or sanitation, the risk of contracting deadly diseases increases dramatically. Every year, 1.8 million people die from diarrhoeal diseases like cholera, and young children are by far the most affected. Over 5,000 children under 5 die each day due to lack of sanitation and hygiene; diarrhoea is the second highest cause of child mortality in the world.(1) Sobering statistics like these are what motivates Medair to make WatSan provision such a high priority in crisis situations. Through short-term emergency relief and medium-term rehabilitation, our WatSan sector focuses on providing essential, life-sustaining support that helps restore health and dignity to our beneficiaries, and helps reduce the workload of many, especially women and children. (1)

UNICEF: International Year of Sanitation, 2008.

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MEDAIR Annual Review 2007

WatSan Need

Medair Action

Hygiene Limited hygiene awareness Poor hygiene practice

• Hygiene promotion, especially handwashing promotion • Education includes classroom teaching, focus group discussions, role-playing, songs, and puppet theatre

Water Supply and Treatment Limited access to sufficient quantities of water, especially safe drinking water

• Drilling boreholes, digging wells, and protecting springs • Cleaning, rehabilitation, and maintenance of water points • Installation of water distribution stations, rainwater harvesting, and gravity-fed systems • Operation of mobile water treatment systems in emergencies • Distribution of water treatment chemicals for households • Construction of household sand filters

Excreta Disposal and Sanitation Limited access to adequate sanitation facilities

• Rapid latrine construction for shortterm emergencies and crowded camps • Latrine construction for long-term use with local materials • Installation of hand-washing and bathing facilities

Solid Waste Management Organic solid waste accumulating, posing a health risk

• Rubbish collection campaigns in camps

Capacity Building Long-term future of water and sanitation in a region

• Training of Village Water Committees • Training of pump mechanics and caretakers • Aspects of sustainable water supply, including groundwater monitoring

Sectors of Expertise

Changing Habits for Better Health Medair’s Water and Sanitation sector provides a comprehensive intervention to improve living conditions in remote Afghanistan. In 2006, Medair surveyed an isolated group of Afghan communities in Wardak and Bamyan provinces and found that safe water sources and latrines were virtually nonexistent. People drank their water directly from the main river or from unprotected springs, and their waste was left in areas where it could easily contaminate the water. Unsurprisingly, a high incidence of diarrhoeal diseases was also found. In fact, most women told our team that they had lost at least one child to diseases, including diarrhoea. “According to villagers in both provinces, everyone suffers from bloody diarrhoea at least twice each summer,” said Torsten Zellmer, Medair’s WatSan Programme Manager. “Approximately 75 percent of women also suffer from urinary tract infections. One of the reasons is because they don’t drink enough water so that they can avoid having to urinate as frequently, lacking the privacy a latrine would provide.” In 2007, we launched a significant WatSan project to meet the needs of these vulnerable communities by building and improving shallow wells, protected springs, latrines, bathrooms, and also delivering hygiene promotion.

fields for six months of the year. Medair works in partnership with communities, so at times when villagers were unable to participate, our progress became slower. Winter also hit the region hard, so work had to stop when snowfall became heavy. However, many new safe water points and latrines were constructed by the end of the year. “People are very enthusiastic, and they are supporting the building of latrines and protection of springs more than we expected at the start of the project,” said Torsten. “The living environment around the households and villages has also been cleaned up, and is contributing to a better hygienic environment.” In Wardak and Bamyan provinces, we were pleased this year to witness new hope among the vulnerable population, as WatSan improvements offered the promise of better health and greater dignity. Photos, left: Making clear progress in Madagascar. right: Medair well-digging in Afghanistan.

An Enthusiastic Response Education about proper hygiene can have an enormous impact on public health, so we made this a major pillar of our intervention. To ensure its success, we trained local residents to become hygiene promoters for the community. “We began in July, and we can already see people changing their habits,” said Haroon, a Medair-trained Hygiene Educator. “During meetings with the villagers we talk about personal hygiene, how to avoid diarrhoea, and how to keep the house clean. More and more people come to the meetings, even if it’s a little bit difficult now because there is work to do in the fields.” Soraya attended a hygiene meeting, and was impressed with what she learned. “I didn’t know that water could give diarrhoea and that latrines shouldn’t be near rivers,” said Soraya. “These are important things, especially for our children. If we pay attention, we can avoid diarrhoea and skin problems, and they will be in better health.” Well-digging and latrine construction proved to be more challenging, because most of the people worked in their 15

Shelter & Infrastructure Medair’s Shelter and Infrastructure sector is positioned to provide life-saving shelter for beneficiaries in emergencies, and to support the Health Services and Water and Sanitation sectors in the process of rehabilitation. Basic shelter is one of the key elements of human survival along with food, water, and clothing. People can only survive a few days in many environments without adequate protection against the physical elements. For example, in the wake of the devastating earthquake in Pakistan, the immediate provision of emergency shelter and household goods (blankets, clothes, cooking utensils, etc.) was essential to saving lives. However, once a population has been stabilised, the focus can shift to the real work of restoring them to a position of self-sustainability. Our Shelter and Infrastructure sector works to rehabilitate - and hopefully improve - the basic infrastructure that existed before a crisis. By combining training and support activities with permanent physical infrastructure, we help ensure that vulnerable communities have both the knowledge and the tools needed to improve their lives.

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MEDAIR Annual Review 2007

Shelter & Infrastructure Need

Medair Action

Crisis leaves people without shelter

• Temporary shelter distribution • Distribution of essential non-food items (NFI kits)

Long-lasting shelter needed

• Semi-permanent shelter distribution • Construction or rehabilitation of permanent shelters

Vital infrastructure needed

• Construction or rehabilitation of schools, health units, roads, and bridges

Support for the long-term future

Capacity Building • Disaster mitigation strategy and implementation • Training in earthquake-resistant construction techniques • Livelihood support • Educational support

Sectors of Expertise

School Time on the Mountaintops Medair’s Shelter and Infrastructure sector provides high-altitude emergency relief and rehabilitation in Pakistan. Ghundi Serrari Government Boys’ Middle School was shaken to its foundations by the earthquake of October 2005. Within a matter of minutes, it became unusable to communities in the remote region of Hajira Tehsil in Poonch District. Medair initiated an emergency relief programme within days of the quake, providing shelter kits and essential supplies to vulnerable families. With the emergency passed, Medair committed to rebuilding 11 earthquake-resistant schools, each with three to nine classrooms, staff offices, latrines, and a clean water supply. However, rebuilding a school in a community like Ghundi Serrari was a serious logistical challenge. Situated in the mountains at an altitude of over 2,000 metres, it was inaccessible to anything but the sturdiest four-wheel drive vehicles. Nobody in the community could see how the school would be able to be restored. But Ghundi Serrari’s remoteness was one of the reasons that Medair identified it as one of our 11 schools to rebuild, thinking it unlikely that the inaccessible school would ever reach the top of the government’s reconstruction plans.

landslides blocked roads and refilled foundations that had already been dug. Meanwhile, construction continued on the other 10 schools, and by June of 2007, we had completed our first school, the Kathiara Government Girls’ Middle School. Just four months later, we completed the school in Ghundi Serrari. At its opening, the whole community turned out to show their appreciation. They came with banners reading, “Thank you, Medair! We are thankful to you for your kindness!” By the end of October, all 11 schools were finished, despite some major obstacles along the way. Lt. General Nadeem Ahmed, the Deputy Chairman of ERRA (Earthquake Reconstruction and Rehabilitation Authority), personally requested that Medair’s Country Director Hylton Cannon fly with him by helicopter, so that the general could see all of the rebuilt schools himself.

Great Challenges, Great Rewards

“The General was very pleased with what he saw, and more so to see for himself the difficult areas where some of the schools were built,” said Hylton. “The communities themselves have been so enthusiastic about the quality of the new facilities. We believe that these schools will serve them for at least the next 50 years.”

Construction began in August 2006, and we soon realised the extent of the challenge before us. Heavy snow constantly hindered construction and access, and frequent

Photos, left: Paspul Clinic in Afghanistan. right: Pakistani girls in their new Medair-built school.

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0 0

50

Uganda

100 km 50

SUDAN

100 mi

Kaabong Abim Pader

DEM. REP. OF CONGO

Uganda Kampala

KENYA

• Post-conflict transition, with pockets of ongoing insecurity • Over 1 million Internally Displaced Persons (IDPs) • Hundreds of thousands of displaced on the move, setting up smaller resettlement sites • One of the poorest countries in the world, with minimal social services • Recurrent drought and severe flooding affected the population in 2007

TANZANIA RWANDA

The Road to Recovery Following the humanitarian crisis in northern Uganda, people are beginning their long journey home and desperately need access to basic services like safe water and medical care. At the end of 2006, Namabili didn’t exist. One year later, nearly 2,000 people are living in this resettlement site, most of whom moved away from a congested IDP camp nearby. Fear of insecurity prevented many Ugandans from returning all the way home in 2007, but moving to smaller sites like Namabili brought them closer to their ancestral lands.

“Seeing beneficiaries start to move nearer to their ancestral homes has been a really encouraging development. People have been able to access more land, and as a result, have the chance to build a livelihood and restore their dignity.”

Years of violent conflict and displacement have traumatised many in northern Uganda. Children were especially affected by this appalling war, with thousands being forced to become soldiers or concubines, and countless others left orphaned like Okot and his sisters. Mass displacement broke down traditional clan structures, without which there were almost no social care systems to help vulnerable children heal.

For 15-year-old Okot and his family, Michelle Wilson, Programme Manager in Patongo moving to Namabili also offered them a fresh start. Their father was brutally killed by the Lord’s Resistance Army in 2001, and then their In 2007, Medair worked to fill this glaring gap by providing mother contracted HIV from another man. She was bedpsychosocial care across the region. In Namabili and other ridden for two years before dying at the end of 2007, leaving locations, we trained Community Volunteer Counsellors (CVCs) Okot and his younger twin sisters orphaned. to support the most vulnerable. A Medair CVC identified Okot and his family as people in need of support, and supplied them with water containers, cooking utensils, bedding, and clothing. The children were referred for counselling sessions, which helped them to deal with their grief. Okot and his sisters have now grown emotionally stronger, and with the gift of a goat, have received support for their future livelihoods. This kind of productive collaboration with CVCs was a great example of the way that Medair partnered with communities last year, working alongside them to find the best solutions together.

From Namabili to Karamoja In Namabili and throughout Pader District, Medair worked through existing health structures to treat over 18

MEDAIR Annual Review 2007

400,000 people who otherwise would have struggled to receive help. We also trained Village Health Teams to provide basic medical care for communities that had returned to their land deep in the bush. Our teams drilled new boreholes and trained communities to repair old ones. To help transfer responsibility to communities, Water User Committees (WUCs) were trained to manage their own water supply, and water distribution systems were converted to solar power. We also trained beneficiaries in Namabili and other resettlement sites to make latrines. This strategy had a multiplying effect, as many more sites had good levels of sanitation by year’s end. Elsewhere in Uganda, Medair was one of only two NGOs to work in the remote Karamoja region, an area devastated by drought, poor health, and chronic underdevelopment. In the face of high insecurity due to ongoing raids by armed warriors, Medair improved water and sanitation in the region, providing new and repaired boreholes and training WUCs to manage them. Following rumours of hunger, we also conducted a nutritional assessment of the forgotten Ik tribe who live in a remote mountain location.

We were encouraged to see communities like Namabili take steps toward self-sufficiency this year, after so many years of being displaced. As they continue on their road to recovery, we will nurture their capacities until they are able to walk on their own.

Programme Highlights Total beneficiaries in 2007

241,500

Medair personnel

18 Internationally Recruited Staff 102 Nationally Recruited Staff

Health Services Emergency Relief • 200 emergency kits to flood victims in 4 resettlement sites • 1 nutrition assessment of Ik tribe, leading to renewed food distribution Rehabilitation • 417,960 patients treated in 5 sub-counties • 16,978 mosquito nets distributed to households and hospitals • 367 Village and Community Health Workers trained • 1,600 psychosocial child counselling sessions held • 16,000 school children given school materials 3 times/year • 2,663 orphans given household kits, clothing, school supplies Water & Sanitation Rehabilitation • 53 boreholes drilled, rehabilitated, or repaired

“Medair visited us and saw that we had no food and were struggling to survive,” said Akot Grace, a member of the Ik tribe. “They informed the authorities, and the next week we received food for the first time from WFP [World Food Programme]. Thanks to Medair we are no longer hungry.” Our teams responded as needed in the event of crises. When the rainy season brought flooding to Namabili in September, the community found itself isolated from local markets, food distributions, and health care. Namabili residents approached us for help, and we worked with them to repair and clear the road.

• 146 Water User Committees trained to maintain water sources • 616 pump mechanics, hygiene promoters and mobilisers trained • 642 latrines completed in over 28 locations • 55,757 people had access to 10 litres of safe water per day • 73,009 people had access to improved sanitation Shelter & Infrastructure Emergency Relief • 1 road rehabilitated to reach 2,000 villagers Photos, left: Medair staff at Ugandan orphanage. right: Family gets clean water at Medair pump.

For more information about Uganda and Medair’s work there, please visit www.medair.org/uganda 19

C.A.R CAMER.

SUDAN Isiro

Congo

REP. OF CONGO

GABON

Equato r

UG. R.W

Lual

ab

BURU.

a

Kinshasa

Dem. Rep. of Congo

Bunia

Kisangani

TANZ.

ANGOLA

0 0

200

400 km 200

ZAMBIA 400 mi

D.R. Congo • Recovering from years of conflict that killed almost 5.4 million people from violence or war-related illness • Over 1 million people displaced from their homes • Ongoing violence and brutality, especially in Ituri region in the northeast • UN officials call it the worst example of sexual violence in the world • Outbreaks of deadly epidemics like cholera and meningitis are common • Very limited health care access for highly vulnerable population

A Moment to Celebrate On 16 June 2007, Medair celebrated ten consecutive years of serving the most vulnerable in DRC, a decade marked by violent conflicts and atrocities that persist to this day. In Zitono village, close to Gety town, longsuffering residents have experienced more than their share of violent insecurity over the past several years. “This area has been attacked so many times and the village has been completely destroyed six times in the last few years,” said Ruth Mutanga, a midwife in Zitono. “Each time, the health clinic has been destroyed as well, leaving us with nowhere for women in labour to go for help.”

and looted health structures for drugs they could sell on the black market. However, despite these pockets of violence, overall security did improve during the year, as the peace process reached many of the roving militia groups.

“I am especially thankful for the rehabilitation of the health structures that were ruined during the war. Now the sick can come to the clinic again to get a better treatment.”

During the year, we provided aid to over one million people in the remote northeast regions of the Uélés and Ituri. We supported 490 health structures with subsidised drugs, monthly supervisions, and training for health staff. Our emergency teams were also Polydor Uketo, a beneficiary from Walendu/Bindi With the clinic in ruins after a 2006 kept busy, responding to major disease attack, Ruth began using her own small outbreaks throughout the northeast. At home as a makeshift maternity ward, sleeping on the floor the same time, our construction teams rebuilt or rehabilitated to make space for patients. In 2007, Medair – the only NGO two dozen health clinics, including the brick structure in Zitono. working in Zitono – sent a construction team to rebuild the health clinic, and they met with Ruth. She was quick to advocate In the end, Ruth got her maternity ward after all. When that we should build a proper maternity ward at the same time. Medair’s construction team returned to the village later in the year, local residents joined with Medair to build her Although everyone acknowledged that a proper ward was a large ward. “Now we’re all satisfied,” says Ruth. “I have needed, the local construction committee voted against it, opting to spend their money on a health clinic made of bricks that would better withstand future attacks. Our construction team agreed with Ruth that a maternity ward was needed, but our role was to partner with the community, not to impose our will. And we certainly understood the fear of the local committee.

Responding in the Face of Insecurity The threat of insecurity was again a major factor affecting Medair’s activities during 2007. In Ituri, militia groups and undisciplined soldiers attacked vehicles to rob passengers, 20

MEDAIR Annual Review 2007

my maternity ward, and thanks to Medair, the community has a clinic built in brick, which will have a better chance of surviving when the area is attacked again.”

the country,” said Alphonsine Unwang, the joint coordinator of SYNERGIE, a local NGO. “Because Medair stayed and continued to act, despite all the violence and danger, it is the most respected organisation in the entire region.”

Reaching out to the Traumatised The war that ravaged this vulnerable population was unfathomably brutal, with rampant sexual violence against civilians, many of them children. In 2007, our teams provided psychosocial training to local residents, particularly in the schools, so that they would be able to help the most affected to recover from these terrible traumas. “We are truly thankful that God brought Medair to Ituri and here to Lolwa in spite of all the difficulties in this region,” said Justin Ngombele, the principal of a primary school in Lolwa. “But I also thank Medair for targeting the schools. It is not easy to deal with the children and I am happy that they are not forgotten.” Medair trained local doctors and nurses in all of our health care structures, transferring valuable technical skills in order to nurture self-sufficiency. We also launched a new project to improve water and sanitation for the population by building latrines, protecting water sources, and installing rainwater collection systems. In addition, we expanded our activities into new areas, including Aungba and Dingila, thanks in part to new donors supporting our work.

“The Most Respected Organisation” Often in the world of emergency relief and rehabilitation, we fix all our attention on the urgent needs that exist, and the work that must be done to address them. Our ten-year anniversary afforded Medair a rare opportunity to reflect on our achievements, and to celebrate the hard work and persistence that has saved many lives and sustained them with the hope of a better future. “What struck me most about Medair is that it stayed during the war, when other health centres and NGOs either closed or left

Programme Highlights Total beneficiaries in 2007

1,068,000

Medair personnel

10 Internationally Recruited Staff 119 Nationally Recruited Staff

Health Services Emergency Relief • 10 disease outbreak responses (cholera, meningitis, rubella, and plague) with approximately 426 people treated Rehabilitation • 1,068,000 people accessed health care facilities • 523 health structures supported, providing primary health care access to 2,500,000 people • 51,520 women gave birth in Medair-supported health structures, with 2,879 caesarian sections performed • 84 tonnes of medication distributed • 197,386 vaccinations given for 5 different diseases • 17,600 mosquito nets distributed • 1000 + health staff trained on medical issues, plus 55 health staff trained on psychosocial issues • 666 community leaders, 1,512 teachers, and 5,754 secondary school students sensitised on psychosocial issues Water & Sanitation Rehabilitation • 22 water sources protected • 100 latrines built • 25 rainwater collection systems installed in health structures Shelter & Infrastructure Rehabilitation • 24 health structures reconstructed or rehabilitated, accessed by 81,669 patients • 1 hospitalisation ward constructed with facilities for 20 in-patients Photos, left: Psychosocial training in D.R. Congo. right: Medair clinic building progressing rapidly.

For more information about D.R. Congo and Medair’s work there, please visit www.medair.org/congo 21

EGYPT

LIBYA

SAU. AR.

Northern States CHAD

Omdurman Geneina

Khartoum

ERITREA

Sudan

West Darfur

Kadugli

Southern Sudan

C.A.R

0 0

300 km 300 mi

DEM. REP. OF CONGO

UGANDA

ETHIOPIA

KENYA

Sudan (Northern States) • Recovering from longest running civil war in Africa, which ended in 2005 • Persistent conflict in Darfur has led to the world’s largest humanitarian response • Very few functioning social services West Darfur • Ongoing insecurity threatens the population and restricts humanitarian access • Over 1.2 million affected people, including 700,000 Internally Displaced Persons (IDPs) Khartoum State • 1.5 million IDPs • Ongoing risks of malnutrition and disease outbreaks Southern Kordofan • High number of returnees • Very limited access to health care or water & sanitation

When the Wells Run Dry In 2007, Medair made every effort to work alongside communities and deliver projects that would make a lasting impact: saving lives today, and sustaining them for a self-sufficient future. Awad Abbas lives in a small village called “The stream water is contaminated and Ruseris that sits in the rocky hills of dirty, but water from the filter is tamaam Southern Kordofan, an area that was a (good) and clean,” said Awad. “If this clinic were not frontline in the civil war just two years ago. here, I don’t know where During the rainy season, all the residents Demand for the bio-sand filters escalated else we would go.” drink from a khor (seasonal stream) that as residents noted that the filtered water Naira Elkheir, beneficiary, West Darfur runs through the village. Although drinking was clear and that there were fewer from the khor can lead to serious illnesses, occurrences of diarrhoeal disease in at least 40 percent of Southern Kordofan gets its water from Ruseris. Meanwhile, the population of Ruseris and other villages unprotected water sources just like this one. across Southern Kordofan swelled throughout the year, as displaced people returned home. With residents and returnees To address this problem, Medair trained Awad and nine now competing for scarce water resources, Awad was able to others in different villages to construct bio-sand filters increase production, constructing filters for 80 households. that would be capable of eliminating the most significant pollutants in the water. As a pilot project, Awad constructed Developing Sustainable Solutions rain-barrel-sized filters for 25 Ruseris households. People Access to safe drinking water is a major concern across Sudan. poured khor water through their new filters, and were Digging boreholes is one method of procuring water, but delighted with the results. many aquifers can only be reached by boring through over 100 metres of rock. “This is extremely expensive, and it does nothing to address the root cause of the problem,” said Ali Lima Mohammed, Medair’s Water and Sanitation Project Assistant. “Underground water reserves are a limited resource.” In 2007, Medair encouraged the population to attempt sustainable solutions to their water needs. Training sessions were conducted on aquifer recharging methods, including sub-surface dams and terracing, as well as promoting biosand filters and rainwater harvesting. Residents are developing the self-sufficiency they need for the day when Medair exits the region. Training local staff and 22

MEDAIR Annual Review 2007

other residents was a major focus of our activities, along with supporting existing Ministry of Health clinics where possible, and working alongside beneficiaries by coordinating with Village Health Committees. In Southern Kordofan, the influx of returnees placed a strain on the minimal essential services that existed in the state. In addition to improving sustainable water access, Medair focused on supporting the health care system. In Khartoum State, our main emphasis was on improving health care for the displaced. We provided life-saving care by supporting static and mobile health clinics that served 50,000 IDPs. In May, we were pleased to receive permission to open a second mobile clinic, this one in Hamas Koreib, where 8,000 displaced families were in need of medical help.

Rising to the Challenge in West Darfur As much as we aim to integrate sustainability into our programmes, there are contexts where this becomes particularly difficult because of dangerous insecurity. In 2007, our operations in West Darfur were seriously hindered for this reason. The threat of violence on the roads meant that UN helicopters were needed to reach our project sites, but insecurity and flight restrictions often inhibited access. Our determined team used creative measures to attempt to reach beneficiaries safely, foregoing the traditional NGO white 4x4s in favour of regular passenger vehicles or donkey carts.

of our staff, and the faith that sustains them. They held the line this year, persisting in their valiant efforts to aid the most vulnerable with nowhere else to turn.

Programme Highlights Total beneficiaries in 2007

415,000

Medair personnel

29 Internationally Recruited Staff 223 Nationally Recruited Staff

Health Services Southern Kordofan – Rehabilitation • 20 health facilities supported Khartoum State – Emergency Relief • 2,500 plastic sheets distributed to assist with shelter during severe weather Khartoum State – Rehabilitation • 50,000 Internally Displaced Persons (IDPs) supported through 1 clinic and 2 mobile clinics • 1,800 homes visited each month with health messages West Darfur – Emergency Relief • 1 Hepatitis E outbreak responded to within 5 days • 20 health facilities supported, with 300,000 patient consultations • 10,000 births attended by Medair-supported midwives • 900 health promotion workers supervised Water & Sanitation Southern Kordofan – Rehabilitation • 7,500 people with improved access to safe water • 4 rainwater harvesting systems completed, and 112 bio-sand filters made West Darfur – Emergency Relief • 3 emergencies responded to, in Bir Dageeg, Kondebe, and Um Shelaya

Despite considerable obstacles, Medair managed to achieve some remarkable results in West Darfur. Our health clinics provided over 300,000 patient consultations during the year, and we maintained safe water access for 130,000, providing capacity building training to national staff and volunteers wherever possible. To have achieved this kind of impact in such a harrowing environment is testament to the dedication

• 130,000 people with access to water supply • 52 mechanics trained to repair and maintain water points • 2,000 latrines constructed Photos, left: Medair clean water source popular with the Sudanese - and their donkeys. right: Sudanese women seeking care in Medair clinic.

For more information about Sudan (Northern States) and Medair’s work there, please visit www.medair.org/sudan 23

EGYPT

LIBYA

SAU. AR.

Northern States

CHAD

Khartoum

Sudan Aweil

ERITREA

Renk Melut Malakal

Akobo

Southern SSudan

ETHIOPIA

C.A.R 0 0

300 km 300 mi

DEM. REP. OF CONGO

Yei

Juba UGANDA

KENYA

Southern Sudan • Recovering from longest running civil war in Africa, which ended in 2005 • Fragile peace, with pockets of insecurity • Very few functioning social services • Some of the world’s worst social indices for nutrition, education, access to water, mother/child health, and outbreaks of disease • Millions of displaced persons • Severe flooding in 2007

On the Move In December, Medair sent a medical team to assist a group of approximately 6,000 nomadic Mbororo people who were in a precarious position, stricken with poor health and marginalised in a remote area of Southern Sudan. Sudan is home to millions of displaced people as a result of the civil war, with many living in the north now beginning to return to their southern homes. However, group movements bring a heightened tension that can lead to violence, as travelling populations exacerbate the strain on the minimal services and resources that exist.

health and hygiene training, and distributed hundreds of bottles of medicinal lotion to eradicate the outbreak of scabies.

“I’m very encouraged because you are training women to take care and protect the borehole. Your training is good, can you do more?”

“We are so grateful for all your help, and especially the vaccinations,” said Abdalla Mohamed, one of the Mbororo chiefs. “Now we feel much safer to travel towards the north.”

The Mbororo people are originally from West Africa, but certain groups have been travelling through Sudan – and This emergency response was just surrounding countries – for decades, one of many effective actions taken grazing their thousands of head of cattle by Medair in 2007. Our emergency Nyanyul Akonjok, Village Water Committee on the land. However, with resources response teams, based in 2007 in so scarce in Southern Sudan, local Loki, were able to respond rapidly to communities became increasingly hostile to them, perceiving emergencies across Southern Sudan. We carried out seven that their cattle were destroying precious crops. As a result, disease outbreak interventions, a malnutrition response, the Government of Sudan granted them land in the Blue Nile and several emergency water & sanitation responses. After state, which many Mbororo claim as their territorial heritage, severe flooding in Fashoda county, Medair and Tearfund staff and where they could safely settle. However, the journey was spent hours trekking through swamps that rose as high as going to take them almost a year to complete. their waists in order to provide emergency health care to isolated villages. The residents greeted them with looks of The nomadic lifestyle had certainly taken a physical toll absolute shock, having never expected to see an NGO travel on the Mbororo. Without reliable access to safe water or to assist them through flooded, snake-infested swamps. health facilities, many of them suffered from severe cases of preventable disease. They had never received vaccinations, “Medair is a very committed organisation,” said local resident and over half of the population was infected with scabies. Eg Chol Deng. “They care about people, and act fast.”

From Emergency Response...

...To Rehabilitation

When Medair was informed about their plight, and asked to provide emergency assistance, we began working to set up a mobile health clinic, and in less than two weeks had vaccinated more than 1,200 children and adults against meningitis, measles, and polio. Our team also provided

We have been an active participant in Southern Sudan since 1992, providing emergency relief and rehabilitation to the most vulnerable. In 2007, we were the only NGO providing primary health care in Melut County, one of the most underserved areas in the country. We continued to expand our health coverage,

24

MEDAIR Annual Review 2007

with several new permanent and temporary clinics established. Meanwhile, our WatSan teams dug new boreholes at depths of 90 to 100 metres, installed hand pumps, dug wells, and set up surface water treatment systems during emergencies in many locations in need. With every project, our Medair teams conducted training to build capacity in health and hygiene promotion and in the maintenance of water systems, fostering a sense of ownership that facilitates the hand-over of systems to the local communities. “We thank Medair so much for the training we have had,” said participant Mary Majok after an intervention. “We will take the knowledge we have acquired to our community members so that together we can improve our village.”

Programme Highlights Total beneficiaries in 2007

298,813

Medair personnel

28 Internationally Recruited Staff 210 Nationally Recruited Staff

Health Services Emergency Relief • 23 emergency assessments • 14 disease outbreak interventions • 1 malnutrition response • 193,990 beneficiaries served through case management, vaccination campaigns, distributions, and health and hygiene promotion Rehabilitation • 1 Primary Health Care Centre constructed and opened • 5 Primary Health Care Units under construction, 4 of them opened • 59,697 beneficiaries

Klaas van Mill, Medair’s Country Director for Southern Sudan, was pleased with the overall programme results in 2007.

• 167 health staff trained at PHCC in Melut County • 305 community members received training to assist with health care Water & Sanitation - Emergency Relief

“We had our challenges, that’s for sure, what with the pockets of insecurity and a very intense rainy season that brought major floods,” said Klaas. “But overall, security improved in the region this year, and we enjoyed a number of positive organisational developments. Our greatest achievement was probably the continued growth of our health care coverage, highlighted by the jubilant opening of our permanent PHCC (primary health care centre) in Melut Town.”

• 8 Emergency Water Treatment Systems installed • 105 latrines • 41,100 beneficiaries Rehabilitation • 6 boreholes and 5 hand-dug wells • 4,026 beneficiaries • 23 water committees trained or refreshed (5 members in each) • 68 health and hygiene promoters trained or refreshed Photo : Medair nurse treating Mbororo woman.

As for the Mbororo, just one month after our intervention, some of them had already travelled as far as Juba. Our staff were gratified to see how much the group’s health situation had improved in such a short time. As they continue their trek to the north, we are monitoring the situation in case further assistance is required, just as we assist thousands of the most vulnerable on their restorative journey toward a better life.

For more information about Southern Sudan and Medair’s work there, please visit www.medair.org/sudan 25

Horseback is the only way for this Medair staff to reach Paspul, Afghanistan, in winter.

The world’s most vulnerable people

26

MEDAIR Annual Review 2007

Transporting Medair vehicles in Madagascar.

Medair staff on the way to ooded villages in Southern Sudan.

... are often the hardest to reach.

Medair staff crossing Wadi Ruei, Darfur, Sudan (Northern States).

27

Maroantsetra

MOZAMBIQUE CHANNEL

Madagascar • Frequent cyclones cause extensive damage and flooding • Over 70 percent of population live in poverty • Very limited access to safe water • Five cyclones or tropical storms struck in 2007

Toamasina

Antananarivo

Madagascar INDIAN OCEAN

0

100 200 km

0

100

200 mi

Good Water in Stormy Weather Every year, cyclones and tropical storms batter Madagascar with destructive flooding, and perpetuate a debilitating cycle of poverty for its most vulnerable residents. The people in the remote northeast of Madagascar are all too familiar with the threat of cyclones. So last March, when Madame Volona heard a warning that a cyclone was approaching, she and her family decided to stay right where they were. Unfortunately, that warning was confirmed on the morning of 15 March, when Cyclone Indlala ripped across the island with 265 km/h winds, causing flooding that submerged entire villages.

“It was as if the sea entered the house,” said Nirina. “We had to evacuate to a small hill, in spite of the wind which became more and more strong. It was terrifying!” Meanwhile, the storm’s fury convinced Madame Volona to flee as well, taking her three children to higher ground in the hills.

“Medair arrived quickly to the place where we were located, even though we thought it to be inaccessible. Thanks to this intervention, we avoided the epidemics of diarrhoea that so often have killed our youngest children.”

For the next week, people throughout the region were stranded on hilltops, without food or access to safe water. In some villages, people lived on their roofs for over five days, surrounded by brown water that became their kitchens, their bathrooms, and their toilets.

In Nirina Rajaonahery’s Nirina Rajaonahery, Antakotako Commune, Maroantsetra District village, he and his family were sheltering at a neighbour’s house. However, the high winds blew the roof away, forcing them to crawl under a table for several hours. There, they Reaching the Stranded Thousands watched in fear as the floodwaters rose higher and higher. Our Medair teams mobilised as quickly as possible to deliver vital aid to the displaced thousands in Maroansetra District. However, transportation in Madagascar is never an easy task. There are no paved roads in the rural areas where we work, only muddy tracks with bridges made from tired wooden planks. Our teams use heavy-duty 4x4 vehicles, and still our drivers require an abundance of expertise and courage just to travel the roads. Of course, many villages can’t even be accessed by roads, requiring hours of walking or boat travel. And obviously, when the island is flooded, affected communities become even harder to reach. After Indlala struck, we swiftly decided that pirogues or flat-bottomed boats offered the best chance of accessing the stranded thousands. Despite the challenges, our teams 28

MEDAIR Annual Review 2007

reached all of the affected villages quite quickly, providing 10,000 families with immediate help. “We were so happy to see the Medair boats with the first help!” said Madame Volona. “They were the first ones to come to the village.” The cyclone season in 2007 was particularly devastating. Even before Indlala struck, a series of storms had caused severe flooding in the capital city of Antananarivo, displacing 25,000 of its poorest residents into overcrowded and unhygienic camps. Medair partnered with UNICEF to install temporary latrines and hand-washing facilities in the camps, and to distribute important items to help improve hygiene and safe water access.

The Success of Rano Tsara Our main project in 2007 was called Rano Tsara, or Good Water, a project that involved establishing partnerships with local actors to help them face future disasters selfsufficiently, and to improve their living conditions over the long term. Together, we focused on constructing water points, providing latrines, improving hygiene behaviour, and preparing for future cyclones. It was a tremendous success in 2007, expanding from three to six communes in Maroantsetra District, and two more in Fénérive-Est District. The catastrophic floods proved to be a profound test for Medair’s methods and the validity of our work with Rano Tsara. Over the last few years, we had worked with local actors to build over 350 water points in Maroantsetra that were designed to be “flood-proof.” So when the floodwaters retreated this year, we had a real-world opportunity to find out whether our water systems were living up to their name. Our investigation revealed that nearly every open well in the region had become contaminated, but almost all of our floodproof water points were in perfect working order, producing clean and safe water that required no disinfection.

“The most vulnerable people on this island continually are affected by flooding that contaminates their drinking water, destroys their belongings, and keeps them from progressing toward prosperity,” said Christophe Roduit, Medair’s Country Director. “But if we can continue to achieve long-lasting results like we did this year, we have faith that a brighter future lies ahead.”

Programme Highlights Total beneficiaries in 2007

150,000

Medair personnel

7 Internationally Recruited Staff 60 Nationally Recruited Staff

Water & Sanitation Emergency Relief • 25 displaced-person camps equipped with latrines and hand-washing facilities • 1,300 open wells disinfected • 2,410 homes and 123 tents disinfected to promote the return of displaced people • 15,049 water purification solutions distributed, along with 13,384 soaps • 50,000 people in 6 communes received emergency hygiene promotion, plus many more within the displaced person camps Rehabilitation • 70 new flood-proof water points built, equipped with Canzee hand pumps • 250 family latrines installed • 6 communal authorities and 35 community associations trained in the management of water infrastructures • 35 women’s associations trained in hygiene promotion • 10,000 people reached by hygiene promotion activities from 18 campaigns • 4 emergency committees trained in cyclone management Shelter & Infrastructure Rehabilitation • 15 bridges rebuilt and 11,000 metres of evacuation channel rehabilitated Photos, left: Families in the aftermath of Cyclone Indlala. right: Medair staff bring help after the cyclone.

For more information about Madagascar and Medair’s work there, please visit www.medair.org/madagascar 29

Indonesia

Banda Aceh MALAYSIA

Gunung Sitoli NIAS ISLAND Teluk Dalam

Indonesia

Jakarta 0

500 310

• Vulnerable to frequent natural disasters • Still recovering from the Asian tsunami • Nias Island recovering from 2005 earthquake, one of the most powerful quakes in history: 10 percent of the population left homeless Hundreds of schools and health clinics destroyed • Limited access to safe water and health care in remote areas

1000 km 620 mi

Spring to Life As residents of Nias Island struggle to recover from recent natural disasters – and seek to gain better access to essential life-saving services – their requests for outside assistance are too often unanswered. During the rainy season, a spring bubbles up in the village of Hilizaria in Lolomatua district, a source of clean, cold water for the 300 people who live here. But at other times of the year, the same spring runs dry and safe drinking water becomes a rare commodity.

“I really appreciate the time Medair takes on community relations. It is something they do really well.”

“They are well aware of natural disasters and diseases, but they lack some of the knowledge and resources they need to deal with these problems. The goal of Medair’s assistance is to bridge these gaps.”

To help foster a productive partnership with Hilizaria, a Village Development Committee (VDC) was established, with members elected by their villages to serve on the VDC as key representatives and decision-makers.

Gregoire Labhardt, Chaine de Bonheur (funding partner), during visit to Nias project

“Our spring has very little water in the dry season,” said Nan Talosa, the head of the local primary school committee in Hilizaria. “When there is one month of dry season, the following week we don’t have any water.”

The community and school board petitioned the government for help, but received no response. Perhaps because of its remote location, Nias Island is sadly accustomed to being forgotten by the outside world. After the tsunami devastated the island, they only received a small fraction of the posttsunami aid that was given to higher-profile regions of Indonesia. Furthermore, in Lomatua district, Medair is the only international NGO providing humanitarian aid.

Working Alongside the Most Vulnerable When our team heard about the need in Hilizaria, we offered our expertise in water and sanitation. However, since residents of Nias rarely receive offerings of outside help, our presence tended to create much local jealousy over who would work with us, even among families. Simple actions like buying local materials and recruiting staff from the community became a source of conflict. “The people of Nias are used to working independently,” said Chris McDonald, Medair’s Country Director in Indonesia. 30

MEDAIR Annual Review 2007

By the summer, Medair and the VDC were implementing coordinated plans to protect the spring and build a reservoir tank. Medair provided technical advice, and supplied materials that were not readily available or affordable locally. We also donated concrete so that a retaining wall could be built for the health clinic, to stabilise it against future landslides. Meanwhile, the village provided volunteer labour for many of the tasks, supplied wood for the concrete forms, and built a fence to safeguard the spring. “The community thanks Medair very much,” said Nan. “Since the spring project has been constructed with Medair, we haven’t had any problems related to water supply.” This successful three-week project was typical of the ways in which Medair seeks to assist those affected by natural disasters in Indonesia. In addition to improving water and sanitation, we also provided health care assistance on Nias Island, including a training programme for health staff, birth attendants, and volunteer outreach workers. Meanwhile, on the west coast of Aceh province, we improved water supplies and built latrines and bathrooms so that tsunami survivors could resettle in new homes.

Avoiding Wildlife, Improving Life Despite some insecurity, our Aceh project achieved many important results for remote communities, improving safe water access for houses, schools, and villages. Women expressed appreciation that they could now bathe in privacy, where previously they had used a screen made from tree branches. Both men and women were delighted that latrines were built close to their homes, meaning they did not have to walk a long distance in the night, risking encounters with wild pigs, dogs, tigers, or elephants.

Programme Highlights Total beneficiaries in 2007

42,200

Medair personnel

14 Internationally Recruited Staff 121 Nationally Recruited Staff

Health Services Rehabilitation • 6,500 mosquito bed nets distributed • 40 Traditional Birth Attendants trained • 5 villages restarted a volunteer health outreach project • 1 local NGO nutrition programme supported through food supply Water & Sanitation Rehabilitation

One of the lesser-known effects of the 2005 earthquake was that the whole coastline of West Aceh dropped by as much as 1.5 metres. This has caused ongoing access problems and flooding of the main roads. In October, our teams conducted an assessment of a hard-to-access flooded marsh region in Aceh that could only be reached by canoe. The assessment team reported that they paddled through crocodile-infested waters and found communities using the swamp for their drinking water as well as their toilet.

• 644 households equipped with bathrooms, wells, toilets, septic systems

“We plan to make a decision soon on intervening there,” said Chris. “No matter where we work, our aim is to partner with communities so that the next time an earthquake or tsunami strikes, people will be able to limit the impact on themselves and their loved ones.”

• 1 health centre reconstruction started

• 162 wells rehabilitated or installed • 11 rainwater collection systems installed in schools and nutrition centres • 19 latrines rehabilitated or installed at 2 schools and nutrition centre • 40 households benefit from a gravity-fed water system • 7 WatSan committees trained to maintain water supply and promote hygiene • 1,500 hygiene kits distributed • 15 local entrepreneurs trained to construct and market bio-sand filters • 1 spring capped and storage tank installed Shelter & Infrastructure Rehabilitation

Photo : Children enjoying clean water source in Hilizaria.

For more information about Indonesia and Medair’s work there, please visit www.medair.org/indonesia 31

UZBEKISTAN

CHINA

TAJIKISTAN

Yawan

TURKMENISTAN

Faizabad

Bamian

Kabul

Behsud

Afghanistan

Jalâlâbâd

In

Kandahâr

dus

Ghazni

PAKISTAN

0 IRAN

0

100 200 km 100

INDIA

200 mi

Afghanistan • Recovering from almost 30 years of conflict • Ongoing insecurity in many regions • Massive neglect and underdevelopment throughout the country: Very limited access to primary health care 70 percent of households lack access to safe drinking water Average life expectancy is just 42 Some of the highest maternal mortality rates in the world • Many districts remain isolated by harsh weather conditions, insecurity, limited infrastructure, and hazardous terrain

New Hope for Paspul For years, Afghanistan has been isolated from many life-saving advancements, but positive changes are taking root in even remote regions. “There is nothing anybody can do for Paspul. There is no help for our village or our district,” said Governor DaMullah Fakhruddin, his voice sounding as hopeless as his words. It was April 2005. Kohistan is known as the “lost” district of Badakhshan province, located in a steep, dark valley that frequently suffers landslides. Farmers scratch out a living in the thin soil, while young people tend to leave for bigger cities.

Improving Health Care in Badakhshan Resistance to change is commonplace in traditional Afghanistan, particularly in the province of Badakhshan. In 2002, it had the highest maternal mortality rate ever recorded, and offered almost no health care.

“Clean water is an enormous change in our lives! During the winter, we will have water and we will have less diarrhoea during the summer.”

Since then, Medair has provided significant health services in the province, with a focus on training people about health and hygiene and on building capacity of national When Medair staff rode into Paspul on staff to run health clinics on their Sharifi Mohammed, resident of Marak, horseback two years ago, they met with own. 2007 saw us take many more Wardak province the disconsolate Governor. He wanted positive strides, with an important to revitalise the village by building achievement being the establishment a new bazaar farther up the hill that would feature more of a comprehensive Emergency Obstetric Care unit. space and offer better access for neighbouring communities. However, Paspul residents were sceptical of his plan. When we first began establishing health clinics in the country, women were often prohibited from visiting them due to the conservative ideas of their families. “It is not easy to change mentalities... People sometimes don’t even want to vaccinate their children because of religious matters and because it gives them fever,” said Seema, a female Medair doctor. “We need to explain to them, and things are changing gradually. ” Indeed, our staff have witnessed encouraging behavioural change in this area. “Great progress has been made, and the situation is constantly improving,” said Gabriele Fänder, Medair’s Technical Development Supervisor. “Where before, women were not even allowed to see a doctor, today more than half of all patients are female.” 32

MEDAIR Annual Review 2007

Reaching Out to Remote Communities In winter, tragedy struck an isolated village, when a series of avalanches killed 14 residents, and injured 65. Despite terrible weather, our health staff left at once, travelling on foot for 12 hours to reach the injured. We followed up with an emergency distribution via helicopter of food, medicines, and blankets. This year we expanded our operations to include the Central Highlands, another isolated region with limited access to health care or safe water. Years of drought and lack of development had created some of the worst food insecurity in the country. We responded with a successful food distribution to help the most vulnerable survive the winter, although the steep roads made accessing the communities quite treacherous. We also worked to improve hygiene awareness and safe water access, digging wells and securing water points to reduce the risk of waterborne diseases. Meanwhile, this year brought great change to Paspul as well, whose Governor was now seen beaming with joy. All of the male community members in Paspul had gathered together for the inauguration of a new health clinic, which we constructed at the top of the hill, next to the site of the proposed new bazaar. Suddenly, the enthusiastic community did not have such a problem with moving the bazaar up the hill either. “We are happy to have this new clinic. Patients will be much better here,” said resident Gul Feroz. “The clinic is going to develop the village because more people will be coming and will maybe buy things at the general store. It’s a hope for us!”

Programme Highlights Total beneficiaries in 2007

101,000

Medair personnel

8 Internationally Recruited Staff 127 Nationally Recruited Staff

Health Services Emergency Relief • 1 avalanche response - medical support for injuries; food, medicine, blanket distribution • 280 vulnerable households (2,000 people) received winter food rations Rehabilitation • 8 Basic Health Clinics (BHC) supported, 4 handed over to national partner • 93 Community Health Worker posts supported, 34 handed over to national partner • 90,600 people accessed health care facilities • 44,632 vaccines administered to 9,000 children and pregnant women • 62 volunteers trained in nutrition, breastfeeding, hygiene education • 1 health subcentre established • 1 BHC constructed in Paspul • 1 Emergency Obstetrics Care building constructed Water & Sanitation Rehabilitation • 1,178 households (9,000 people) provided with safe water points • 30 wells completed, 35 springs protected • 235 community latrines, 130 bathrooms completed • 12,251 participants in hygiene promotion events Photos, left: Hygiene education lessons in Afghanistan. right: Medair staff delivering medicines on horseback to Paspul clinic.

For more information about Afghanistan and Medair’s work there, please visit www.medair.org/afghanistan 33

UZB.

TURKM.

TAJ. CHINA

Islâmâbâd AFGHANISTAN

IRAN

KASHM

IR

Râwalpindi

Pakistan

u

s

Ind

INDIA

Hyderâbâd Karâchi

0 100 200 km 0

100

200 mi

Pakistan • Massive earthquake in October 2005: 73,000 dead 128,000 injured 3 million without shelter • Mountainous and impoverished areas suffered the most damage • Over 80 percent of the population in remote Poonch district were affected • Hundreds of government schools were damaged or destroyed

Rebuilding from the Ruins In an instant, the earthquake made widows of many Pakistani women, who then faced the harsh reality of having to earn an income in order to survive and care for their families. Safia Jabeen was just 21 years old on that terrible October day in 2005. The quake killed her husband and destroyed her home, changing the course of her life forever. She and her young child were left to grieve, without a place to live or a source of income to sustain them.

to restore the livelihoods of people affected by the quake. In previous years, we had given water buffaloes to families and provided people with seed distributions. However, in 2007, we decided to target our efforts specifically at women who were unable to support themselves or their families.

In remote and mountainous Poonch District where Safia lived, our Medair teams launched an urgent emergency response just days after the earthquake. We distributed thousands of tents and temporary shelters to protect the most vulnerable from the winter elements.

Working in close partnership with the local NGO NRSP (National Rural Support Programme), Medair opened sewing centres in 12 different locations in Poonch. Over the year, there were almost 320 students in the programme, who learned not only how to make clothes for themselves and their families, but also gained valuable incomegenerating skills.

“I had no house, but Medair gave me a shelter which was very nice,” said Safia. “I lived in it in peace. I spent the whole winter season in it.”

For 20-year-old Zohra Sharif, the sewing centre created new opportunities for her, and gave her a new perspective on life.

However, what Safia needed most was a way to generate some income. Unfortunately, there were very few “This centre made me think and believe that I can do opportunities for unskilled women workers like her. something myself, and help my family with an income,” said Then one day in 2007, she heard about a new sewing Zohra. “I am very happy with its support.” centre being opened in upper Kathiara. At the centre, she was amazed to discover that Medair An Ambitious School was providing women with sewing Reconstruction Project equipment and skills training so that Another of our major achievements they could earn a living. “Machines, in 2007 was the reconstruction of “We highly appreciate chairs, clothes, and all other materials 11 earthquake-resistant primary Medair’s efforts to work in were free from Medair!” said Safia. and middle schools in remote areas. difficult terrain and hard “I did not pay any fees. I learned sewing, This was an enormous challenge weather conditions... (It) was cutting, and hand-embroidery, and now for us because of the logistical a great contribution... helping I am able to do tailoring work.” problems of conducting such a to ensure a bright future for significant engineering project in our next generations.” Restoring Livelihoods difficult mountainous terrain. The Raja Tariq Mehmood, Programmes Manager, The sewing project in Kathiara was just weather didn’t help either, with the Poonch District Reconstruction Unit (DRU) one part of a broader Medair initiative worst monsoons in 15 years causing 34

MEDAIR Annual Review 2007

landslides and road blockages that inhibited access to sites and filled in foundations that had already been dug. Despite the delays, the last of the schools was fully completed in October, an event that was celebrated with a grand opening ceremony. “It was a very exciting time for the students, teaching staff, and the whole community,” said Hylton Cannon, Medair’s Pakistan Country Director. “There was a huge crowd attending, giving out garlands of flowers, yes even to the men, and what joy in their faces! Suddenly all of the struggles we’d had to get to that point seemed worth it.”

Medair Departs from Pakistan The end of October marked the conclusion of Medair’s programme in Pakistan. All of our objectives were successfully completed, and our beneficiaries and the authorities were very happy with the quality of our work. “We are leaving almost exactly two years after the earthquake, and have achieved a huge amount in that short time,” said Mark Screeton, Medair’s Desk Officer for Pakistan. “The population is stabilised, people have shelter, and the government is slowly getting up to speed, with longterm development plans which will take years and years to realise. Our mandate is fulfilled.”

Programme Highlights Total beneficiaries in 2007

4,004

Medair personnel

5 Internationally Recruited Staff 17 Nationally Recruited Staff

Water & Sanitation Rehabilitation • 11 schools provided with a protected water supply • 8,801 feet of piping installed, along with concrete tanks and source protection • 50 toilets and hand-washing facilities for the 11 schools Shelter & Infrastructure Rehabilitation • 11 earthquake-resistant schools built and furnished with desks, chairs, and benches • 45 classrooms and 22 offices in the schools • 1,230 students and 35 teachers served by the schools • 12 sewing centres established • 318 women received training in sewing and business methods • 21 women trained to be sewing centre teachers • 120 sewing machines, 60 embroidery machines, plus other furniture provided • 2,400 (approx.) family members supported by the sewing project students and teachers Photo : Sewing skills produce new family income in Pakistan.

For more information about Pakistan and Medair’s work there, please visit www.medair.org/pakistan 35

This year over 1,000 Medair staff worked in some of the world’s most vulnerable countries Here are just a few of their stories:

has its own rewards, as she gets to be part of most of the new programmes, becoming acquainted with many cultures, and constantly meeting new people.

Heather Amstutz Emergency Field Manager

Heather highly recommends working at Medair, even for just one year. She says that the experience has changed her forever. “I don’t think you can be around people who are experiencing great suffering and not be changed,” she said. “You develop a much more balanced view of life.”

Heather has one of the most fascinating and challenging jobs at Medair. As the Emergency Field Manager, she is one of the first staff to arrive in a country to respond to a major crisis or disaster. An American citizen, she now lives a nomadic life: in her six years with Medair, she has worked in eight different countries. Before joining Medair, Heather worked for more than a decade as an engineer. Then in 2001, she made a significant career change and began working as a logistician in Angola for Medair. She was attracted to Medair because of its faith-based values, its lack of bureaucracy, and its focus on working in difficult areas. Her former professional experience was a great preparation for this new field of work. She was able to work in isolated and physically demanding areas, as well as in cross-cultural environments, and had developed the confidence, persistence, and initiative to make things happen quickly. “This is the work I really enjoy: finding solutions to problems in a new location, so that we can deliver the right assistance at the right time to the right people,” said Heather. “I’m always amazed at the resourcefulness of our staff and the local people to figure out innovative solutions to the problems at hand.” She does find it hard to keep leaving her teams and communities when she moves to new locations. But this

36

MEDAIR Annual Review 2007

Angelina Chuol Ruot Cook and Laundry Manager SOUTHERN SUDAN Angelina is an excellent cook and laundry manager, so it’s no surprise that her services are in high demand in Malakal. In the past year, she received offers from her former employer and also from the U.N. to leave Medair and come work for them, at double the wage! But Angelina chose to pass up the opportunity to make more money, so that she could continue to work for Medair. “I would like to stay with you,” she said, “because you greet me every morning with a hand and a salaam. You try to learn the language I speak. And I heard you praying for me during devotions, so I know God will bless me through you. I’m not just a helper who is hardly noticed, I feel like I am part of Medair.”

Behind the Scenes

Dominique Rousseau Country Director D.R. CONGO

A native of France, Dominique spent 15 years working in the corporate sector, mostly as an I.T. manager, until he felt the need to be doing something with greater personal significance. He joined Medair in 2005, taking a one-year sabbatical from his job to become a Logistics Manager in Uganda. Medair was impressed with his professional management skills, and after his one-year contract expired, offered him the position of Country Director in D.R. Congo. Dominique’s previous management experience served as important preparation for this new role, but he had to adapt to the richness of living with – and managing – a multinational team, while also adjusting to humanitarian principles over traditional business imperatives. Dominique says he appreciates that Medair people work together to resolve their problems. “We all share common values, and I can also work in line with my personal values.” He enjoys being in Africa, especially spending time with African people in their own culture and country:

Gabriele Fänder Technical Development Supervisor AFGHANISTAN A nurse originally from Falkenau, Germany, Gabriele now uses her skills and training to help some of the world’s most vulnerable people. She began working in Afghanistan in 2004, and her presence has made a lasting impression on the community. In Afghanistan, it is very unusual for a woman to travel around the country and negotiate with authorities, village elders, and doctors. The first time Gabriele came to the villages, some of the elders would not look at her at all during meetings. Once, a mullah left the room immediately when he saw that a woman was present for the meeting. Despite these challenges, Gabriele has risen to the task with great success. One of the things that helped her immensely was that she learned the local language, which many local residents have found fascinating. “Men greet me now when I walk or ride on a horse in the region,” she said. “In the villages, people know my name, and the village elders greet me in a very friendly way, and we’re even joking with each other.”

“We have a lot to learn from African life. You have a very different approach to life when your life expectancy is only 47 years. African people are far less materialistic than we are. In the West, we have a false sense of security. People in Africa rely a lot on God. They enjoy each day, and are very grateful to God, even for small things.”

37

Behind the Scenes

Klaas van Mill Country Director SOUTHERN SUDAN Anne Reitsema Projects Coordinator WEST DARFUR SUDAN (NORTHERN STATES) Anne was born into humanitarian work as the daughter of Dutch missionary parents in a South African conflict area. She says she grew up “counting gunshots at night, and hearing bombs blow up huts. That shaped my childhood.” Anne studied social work and counselling, and was a natural fit for Medair, starting in Zimbabwe. Her initial goals were to work with children or counselling, but instead she found herself responsible for a school feeding programme, keeping a fleet of 20 motorbikes, and six 4x4s maintained. Although she was no mechanic, she found the experience positive and learned a lot from it. “Ultimately it was about staff management,” said Anne. “and learning a whole new technical side of humanitarian assistance in a field context.” Anne next helped resettle returnees in Angola, dealing with a range of people: some walking back through minefields from Zambia, others being flown back by the U.N. – some having not been home for 40 years. Her next job took her to Uganda, where she worked as the Deputy Country Director, overseeing psychosocial and water and sanitation programmes.

After 20 years of senior-level experience in the corporate sector with The Gillette Company, Klaas, a Dutch citizen, felt led to change careers. He wanted to make a difference in the world, to touch people’s lives. However, at first he couldn’t see how someone with his skills would fit into the humanitarian sector. A fortunate meeting with Medair’s ex-Operations Director convinced him otherwise. “She told me that Medair needed experienced managers almost more than anything else.” Klaas started with Medair in a senior position as the Deputy Country Director for Southern Sudan. He inherited all of the responsibilities that went along with it: report-writing and logistical and financial management, as well as an extensive staff, most of whom had been in the organisation longer than he had. He went through a very steep learning curve in his first few months, getting to know the humanitarian context, but was encouraged to find that his management skills were transferrable from the corporate sector. Soon he began craving more work and more responsibility, and Medair responded to his initiative, adding fundraising and security management to his portfolio, along with training new managers as they came to the field.

Anne has now taken on the task of Projects Coordinator in West Darfur, Sudan. Although she still gets some time with beneficiaries, she mostly manages different aspects of the programme and leads the large West Darfur team.

Klaas believes in a coaching style of management. “You can never come into a role like this and say to people, ‘This is how we’re going to do it!’ No, you need to say, ‘Hey, this is where we are,’ then together with the team evaluate the changes in context, and look at strengths and weaknesses. After that process, it is possible to set the direction for the programme together. Not make it a top-down process, but make it a joint process.”

“I like Medair. I’ve always told the teams I’ve worked with that ‘We are Medair,’” said Anne. “If we don’t like something, we can talk about it and change it. You can even talk to the CEO if you want. We’re small enough for that. We’re clear about what our values are – from the top to the bottom.”

Now Country Director, Klaas has found that working in Africa presents constant challenges, but that the job is immensely rewarding. “From a personal perspective, I grow from it. And because you do your work everyday with compassion, you grow from it spiritually as well.”

38

MEDAIR Annual Review 2007

The Value of People Freelance photographer Layton Thompson captures powerful images in crisis situations around the world. After paying a visit to Medair’s Uganda programme, he reflected on his experience. I have never seen a welcome quite like the greetings exchanged among Medair staff in northern Uganda. It’s unique. I first noticed it in Abim when a few team members returned to the base. There was a whole lot of joy, laughter, excitement, embraces – it was lively. Then after a week in different camps, teams returned to the Patongo base, and the greetings between Medair staff – national and international staff included – was exuberant. This vibrancy gives a good reflection of what matters to Medair staff in Uganda: the value of people.

had malaria. On the second evening, a father came with his four-year-old daughter in his arms, and she was shivering constantly. She too had malaria, and after an injection was soon looking a lot better. This experience led me to wonder: what alternative would people have if Medair didn’t stay in these camps? Photos, top: Layton Thompson captures joyful Medair staff reunion. bottom: Layton Thompson portrait of Ugandan beneficiaries.

I was struck by the commitment Medair staff give to their work. No other NGO stays in the camps, whereas Medair will place teams there from Monday to Friday. Working and living on-site makes the staff available at all hours when people are desperate for care. On two evenings as we bedded down for the night, there were knocks on the door. The first night, a young girl was brought to us complaining of severe stomach cramps. As she lay on the ground, Medair staff examined her by the light of their head-torches (as there is no electricity). The little girl 39

Making a Lasting Difference Medair’s major funding partner Swiss Solidarity travelled with us to Iran this year to evaluate the impact of our work, three years after the Bam earthquake. When the 2003 earthquake struck, Medair launched a massive relief and rehabilitation programme in Iran. One of our biggest projects was the construction of 516 houses, and Swiss Solidarity/Chaine du Bonheur (CdB) partially financed the completion of 373 of them. More than a year after the programme closed, CdB decided to evaluate whether our work had fulfilled expectations, and how it had benefited the community. Hylton Cannon, Medair’s former Country Director in Iran, was asked to accompany CdB’s evaluation analyst, Mr. Grégoire Labhardt, on the return trip to Bam. “One of the major concerns we had when constructing the homes,” said Hylton, “was to ensure that seismic or earthquake-resistant specifications were used. However, it was impossible to predict if these specifications would actually stand up to an earthquake.” However, in early 2007, Medair’s houses were put to a severe test when a 5.3-magnitude earthquake struck again in Bam. “As one can imagine, I had no idea what we were going to find when visiting the projects,” said Hylton. “‘Wow’ is the word to use! We were met by very happy beneficiaries at all the projects we visited, and yes, the houses were intact with no damage from the earthquake at all.” Mr. Labhardt was also enthusiastic, expressing that he was “really pleased by the results.” His evaluation concluded that the quality of Medair’s construction work was good. He also concluded that Medair had built good relations with beneficiaries, and that Medair’s staff involvement was strong and “one of the main factors for the success of the project.” In addition, Mr. Labhardt noted that our beneficiaries demonstrated a strong feeling of ownership of their homes, with some doing extra work on them, and generally taking good care of them. All of the beneficiaries expressed gratitude for the support they had received. 40

MEDAIR Annual Review 2007

A Long-Lasting Impact One such beneficiary was Rababi Rangbar, a widow who had been supporting her family by sewing until the earthquake destroyed everything she owned, including her sewing machine. In 2005, Medair started a sewing project, hiring Rababi as the instructor, and the project was left in her hands when we exited the country. When Hylton returned this year, he was pleased to find the sewing project fully functional under Rababi’s leadership. She trains about five students every month and has even offered some of them employment. She was so grateful to Medair for giving her the opportunity to start her life over again. For Hylton, returning to this once-devastated site was very meaningful. To see beneficiaries empowered and Medair’s projects continuing to thrive independently spoke not only to the sustainability and longevity of our rehabilitation efforts, but also to the perseverance of the human spirit. “I would like to thank Medair for its work,” concluded Mr. Labhardt. “According to what I have seen, I could note that the money spent by the people of Switzerland was used effectively: it brought relief to the people of Bam, helped them to recover from the earthquake, and the support brought by Medair got a high degree of satisfaction from the beneficiaries.” Photos, left: Hylton Cannon speaking with Medair contractor. right: Medair house in Bam.

Funding Partners 2007

By order of donation size, in excess of $20,000 USD

United Nations Partners

Institutional Partners

• United Nations Development Programme - UNDP

• Aligro (CH)

• United Nations Children’s Fund - UNICEF

• Tearfund (UK)

• United Nations World Health Organisation - WHO

• Swiss Solidarity (CH)

• United Nations Fund for Population Activities - UNFPA

• Metterdaad (NL) • ZOA Refugee Care (NL)

Governmental Partners

• Pierre Demaurex Foundation (CH)

• Humanitarian Aid Department of the European Commission

• Agha Khan Foundation - AKHS (CH)

- ECHO (via Medair UK)

• Inter-Church Organisation for Development Cooperation (NL)

• Office of U.S. Foreign Disaster Assistance - OFDA (US)

• Tearfund (NZ)

• Swiss Agency for Development and Cooperation - SDC (CH)

• Red een Kind (NL)

• Department for International Development - DFID (UK)

• Dorcas Aid International (NL)

• Europe Aid Cooperation Office of the European Commission

• Woord en Daad (NL)

- EuropeAid (via Medair UK) • Swedish International Development Cooperation Agency - SIDA (SE) • Department of International Development - DFID (UK, via Arcadis) • Ministry of Foreign Affairs - BuZa (NL) • Embassy of France - (MDG) • Northern Uganda Rehabilitation Program - (EU-NUREP) • Bureau Central de Coordination - BCECO (World Bank) (DRC)

• Tearfund (NL) • CARE International (US) • Cedar Fund (HK)

We are also very grateful to our private donors. We wish to thank all of them for their generous support, without which we could not fulfil our mission. Photo : Woman at Medair protected spring.

41

Accreditations ISO 9001:2000 certification Worldwide

EU-CORD

ISO 9001:2000 quality certification worldwide signifies

Medair is a member of the EU-CORD, an EU network of

that Medair effectively delivers goods and services with a focus on

organisations in relief and development, formed in 1998 with

beneficiary needs.

the goal of serving the poor more effectively and improving the conditions of disadvantaged people in the world.

ZEWO Switzerland ZEWO certification, only available to state-approved

HAP-I

Swiss organisations, testifies to the intended and effective

Medair is a member of HAP International, whose purpose is to

use of private donations. ZEWO certification testifies to

achieve and promote the highest principles of accountability,

the integrity of Medair’s publications and, in particular,

through self-regulation by members linked by common respect for

its fund appeals. ZEWO standards call for optimal accounting

the rights and dignity of beneficiaries.

and operational transparency, confirmed by continuous independent monitoring.

ImpACT Coalition, UK Medair UK is a member of the ImpACT Coalition, which promotes

RfB The Netherlands

better understanding of how charities work and the benefits they

The RfB certification gives donors a high degree of

bring to society.

certainty that resources received by the Dutch office of Medair are used for the purpose for which they were given.

People in Aid Medair is a member of People in Aid’s “Code of Good Practice in the management and support of aid personnel.” This code reflects

Awards

the growing attention of aid groups on issues of health and safety, diversity, and equality, and is relevant for agencies engaged in Intelligent Giving, UK

development and advocacy as well as emergency response.

In 2007, Medair UK ranked #1 out of 195 UK charities of its kind for quality of reporting by this independent

The Fundraising Standards Board, UK

organisation that researches and ranks charities for transparency

The Fundraising Standards Board (FRSB) is the self-regulatory body

and quality of reporting.

for fundraising in the UK, members of which agree to adhere to the highest standards of good practice with their fundraising activities.

Memberships

VOICE Medair is a member of VOICE, a network of NGOs throughout Europe

ASAH, France

that are active in the field of humanitarian aid, including emergency

ASAH is a federation of faith-based organisations dealing in

aid, rehabilitation, disaster preparedness, and conflict prevention.

international solidarity in fields such as humanitarian aid, international cooperation and development, fair-trade, and

Principles

societal re-integration. International Red Cross CONCORD

Medair is a signatory to the “Code of Conduct for the International

Medair’s EU-CORD membership gives it membership into CONCORD,

Red Cross and Red Crescent Movement and NGOs in Disaster Relief.”

the European confederation for relief and development. Sphere Coordination SUD, France

The Sphere Project was launched in 1997 by a group of

Medair France is a member of this coordinating body of French

humanitarian NGOs and the Red Cross and Red Crescent movement.

NGOs, whose aim is to promote their values to private and public

Sphere issued a handbook, a broad process of collaboration, and an

institutions both in France and abroad.

expression of commitment to quality and accountability.

42

MEDAIR Annual Review 2007

Impressum Editor-in-Chief: Randall Zindler Managing Editors: Lynn Denton, Mark Wallace, Timothy Chapuis Copywriter: Mark Wallace Content Consultant: Mark Screeton Image Editors: Sandra Alefsen, Sarah Deriaz Contributors: Medair staff around the world Graphic Design Concept: Barefoot Creative, Canada Graphic Design: Brain4You, Belgium Printing: Brain4You Photo Credits: Images were taken by Medair staff with the exception of: Front cover, pp 6, 9, 14, 15, 16, 32, 41, 43, back cover © Medair/Odile Meylan; pp 2, 7, 8, 18, 43 © Medair/Mélanie Frey; p 7 © Medair/Michel Bührer; p 37 © Vianney Prouvost; p 39 © Layton Thompson. Names of people and places in articles were changed when deemed appropriate to protect the identity of beneficiaries and staff. Internationally Recruited Staff are reported as number of positions, and Nationally Recruited Staff are reported as number of people in 2007. © Medair, 2008 The information contained herein may be reproduced with the prior, written approval of Medair. Medair requires a copy of the publication in question. An electronic version of Medair Annual Review 2007 – Our Values in Action (available in English, Dutch, French, or German) is available for download at www.medair.org. Disclaimer: The presentation of maps in this review does not imply on the part of Medair the expression of any opinion whatsoever concerning the legal status of any country or territory, or its authorities, or the delimitation of its frontiers. Detailed and up-to-date information on Medair’s country programmes, as well as Medair’s 2007 Annual Report with consolidated financial data, can be found on www.medair.org or by requesting in writing to the international headquarters. For more information, please contact Medair using the contact information on the back cover of this report or visit www.medair.org.

43

Medair International HQ Chemin du Croset 9 CH-1024 Ecublens Switzerland Tel: +41 (0) 21 694 35 35 info@medair.org

Medair France 1 rue Bizet 26000 Valence France Tel: +33 (0) 475 59 88 28 france@medair.org

Medair Germany Kรถhlerstr. 3 82110 Germering Germany Tel: +49 (0) 89 82 00 09 73 deutschland@medair.org

Medair Netherlands Amsterdamseweg 16 3812 RS Amersfoort The Netherlands Tel: +31 (0) 87 874 11 10 nederland@medair.org

Medair Switzerland Chemin du Croset 9 CH-1024 Ecublens Switzerland Tel: +41 (0) 21 695 35 00 suisse@medair.org

Medair UK Unit 3, Taylors Yard 67 Alderbrook Road London, SW12 8AD, UK Tel: +44 (0) 20 8772 0100 united.kingdom@medair.org

Medair US PO Box 4476 Wheaton, IL 60189 United States of America Toll Free 1-866-599-1795 united.states@medair.org

Charity Registered in England & Wales No. 1056731 Company Registered in England and Wales No. 3213889

Photos, front cover: Family at Medair pump in Madagascar. back cover: Curing concrete for Medair hand-dug wells, Afghanistan.

www.medair.org


Medair - Our values in Action