Voices from the field - Emergencies

Today was the last day of the Shafallah forum. This has been an exciting experience with lots of exchanges of knowledge and experiences.

Thanks to CBM partners who presented their experiences and mentioned the good and important support they received from us. The St-Boniface Hospital in Haiti shares with the audience how they can keep in touch with persons with disabilities because CBM provided them with funds to buy phone and credit to persons with spinal cord injuries. This being crucial in making sure that people are not isolated and keep themselves in good health enjoying their life.

Another highlight of the conference was when we had the opportunity to briefly introduce CBM to Prince Mirad Al Hussein of Jordan who during his speech at the Gala Diner showed a real commitment to disability issues.

Well I'll be flying back tomorrow morning with a very good feeling and proud to be working with CBM and knowing that our work is very important to our partners.

I'm currently in Doha participating in the 5th International Shafallah Forum, which this year is about Crisis, Conflict and Disability: Ensuring Equality. The Shafallah Center is a model centre working with children with special needs.

Today was the first day of the conference. It was attended by more than 10 first ladies from different countries and it is placed under the patronage of Her Highness Sheikha Moza Bint Nasser.

The conference gathers about 300 participants from all over the world, including persons with disabilities themselves. Today one of the keynote speaker was Valerie Amos, the UN Under-Secretary-General for Humanitarian Affairs and the Emergency Relief coordinator. Baroness Amos addresses disability issues as being key in humanitarian operations. In her speech she mentioned the work of CBM and talked about the situation of persons with disabilities during food crisis but also currently in Philippines. I had a chance to approach her and introduce briefly the work of CBM and partners in responding to emergencies. I hope that her commitment will make a real change.

We also had the chance to listen to different panels of discussions - all very interesting including some opening talk from Mr. Ron McCallum, Chair of the UN Committee on the Rights of Persons with Disabilities, among other very prestigious invitees.

The Shafallah forum also adopted an innovative approach to presentation having top level journalists moderating the panels and humbly they all recognised their ignorance about disabilities and the need for media to get involved in reporting situation of persons with disabilities in crisis, conflict of disasters - let's see if they will do so in future.

I hope that all the discussions that happened today will really make a difference and raise awareness on the situation of persons with disabilities in emergencies. I'm happy to be here and meet old friends I worked with since many years, build up new connections and understand others' perspectives.

It is very nice to see country like Qatar taking steps forward to improve the living conditions of persons with disabilities and as mentioned by Cherie Blair (co-chair of the Forum) Qatar is going to play an important role in disability issues at a global level in the coming years.

As the Emergency Programme Manager based in Kenya, one of my duties is be in touch with the partners working in the field on a regular basis. This is to develop a better understanding of the interventions, to suggest and guide changes whenever required and to guarantee a proper utilisation of the resources which - thanks to our supporters - have been provided by CBM.

Additionally, as a team, we follow-up and analyse the development of the situation through several ways such as reading and analysing the information shared by the international humanitarian forums, through meetings and exchange of updates with other implementing organisations and most importantly through field missions carried out by the CBM Team.

The food distributed by CBM and its partners since August 2011 provided a crucial support to thousands of disadvantaged families during the hardest periods of the food crisis. For example, in the Tharaka District of Kenya, which is one of the areas covered by the CBM food relief program, it is estimated that half of the population is in need of food aid. Furthermore, this area has one of the highest incidences of poverty and the highest prevalence of disability within the country.

Despite the fact that most of the population within the drought affected areas is in need of support, CBM felt that it was important to look for the most vulnerable and at risk within the targeted communities. For this reason, food aid was provided above all to those households with persons with disabilities, children with disability, children under five, pregnant and lactating mothers, elderly people, and with family members affected by chronic diseases.

This approach provoked some interesting reactions, such as a family finally disclosing the presence of a disabled child within their household. Local communities and tribal groups have different cultural attitudes toward families who have children with disability and children with disabilities themselves. These attitudes are generally associated to poor literacy, lack of awareness, local beliefs and many other reasons. The need of food and the targeting of children with disability encouraged families to move outside the confinement of the household, to the food relief sites. Although this response was induced by a necessity, it was an opening which CBM used to pass important messages about disability inclusion and rights for children with disability. That said, attitudinal and cultural changes do not happen overnight and meticulous work is still needed.

Another issue which we noticed during our work is that, as well as persons with disability, mothers of children with disability face a number of extra challenges during an emergency and during the follow up aid interventions. One simple but very common example is the distance they have to cover, often walking for hours from their village to the distribution sites.

The needs and challenges faced by persons with disability and their families remain a specific focus for CBM, especially in times of emergency, when their lives may be at risk if they don’t get enough support.

This is why mobility devices such as wheelchairs, crutches and walkers have been distributed through a partner to persons with disability living in the refugee camps located in eastern Kenya (currently the largest refugee camps in the world) that hosts half a million Somali people. This simple intervention is crucial to guarantee access to important programmes such as food relief and provision of health services (including immunisation and screening) within the camps.

The partnership with the Kenya Red Cross has been developed along the same lines, so that persons with disability become a specific focus within their relief activities in the areas of health and food relief. Such a partnership is a way for CBM to maximise the impact of aid in favour of persons with disability.

The context and nature of the problem is changing week by week. Therefore a more flexible approach is required. On one side we have to deal with the effects of the drought (food-shortage) and continue to provide relief during the next months. On the other hand, we need to empower the community so as to reduce their level of vulnerability as they will be more capable to face such challenges in the future. This is done through the provision of seeds and agricultural tools so that fields can be ready for the upcoming rainy season. The quantity and quality of the next harvests will be crucial. If farmers will have good harvest during the first trimester of next year, they will have food to face the months to come and be able to wait until the next rainy season. Additionally we train people in water harvesting and micro irrigation.

Building up the capacities of the local community to cope with the current situation and to get ready for possible new crises is efficient and proves very cost-effective. We believe that supporting disadvantaged people to go through the food-crisis and helping them to regain their autonomy and dignity is good use of our supporters’ money.

Today the country coordinator of Ethiopia, Mr Tigabu, has arrived in Nairobi. We had a long discussion on the situation there and how CBM could support emergency responses there. We still need to collect more information but we have good ideas and I’m confident that we will also be able to develop some response in Ethiopia.

We also had the visit of some partners. Sister Judith from St-Lucy Special Need education school came with pictures of the children leaving the school for holidays with food supplies and hygiene kit for the girls. Sister Judith explained to us all individual stories and gave us many details on the difficult situation some of the children and families are facing.

Five of the children remained at the school as their parents are pastoralists and they do not know where they are currently. They have probably tried to move to find food and water for their cattle and may not come to pick up their children, knowing that the sisters will take care of them.

The sister told us that all the children are really looking forward to go back home and spend some time with their families, however they may not be aware of the situation they will find once home as they most of the time stay within the safe environment of the school.

Sister Leonora from St-Oda school also wrote to us explaining that she had supported families with transportation to come and pick up their children. She wrote that she will take time to visit them during the holidays to make sure they are fine and receiving sufficient food and care from their families.

This is probably one of my last blog from the field until my next mission as I’m going back to Europe on Wednesday but we are already planning for my next trip this time most probably to Ethiopia in few weeks. 

I would like here to say also a word on how the CBM Regional Office staff, the country coordinators and the partners have been supportive to the development of the emergency strategy. People have given time and energy to help us and are very committed to support the poorest of the poor. It is great feeling and team work and hopefully together we can continue to do more…

Wednesday, 27 July 2011 - Nairobi

Last night it rained a lot in Nairobi, which is not normal at this time of the year. It should normally only start in about two months. I wish this could have been the same in the north and north-eastern region of Kenya but I know it hasn’t. In fact, if heavy rains come now in the affected areas and the temperatures drop, that will bring another set of challenges in the support of the population - the fields are so dry that the water will just flow over and inundate the areas, increasing the risk of water-borne diseases, for example.

My colleagues, Linda and Greg, are since Monday in Moyale, a border city with Ethiopia. They’ve visited villages in the areas and met persons with disabilities to try to understand their situation. One of them said that nobody thinks about persons with disabilities in times of emergency and he was happy that someone asks about their situation. Linda and Greg will be back tonight and I think Linda will add about her experiences on this blog later this week.

It is Sunday evening and we are back from the field visit in Eastern Kenya with our partner the Diocese of Meru. We visited the district of Tharaka North, it was very dusty and we walked into very dry areas to meet with persons with disabilities and their families.

This was a long day listening to stories all of them telling us the same thing: “we haven’t had any harvest since nearly 2 years now, we have a meal a day made of a little bit of maize and water, and we don’t remember the taste of vegetables or fruit, it is so long that we haven’t eaten any!” The life in this part of Kenya is difficult, to find few litres of water. People have to walk for hours every day, one father told us that to bring back 60 litres of water for his family of 13 members he needed to walk three hours one way.  Can we try to think about how many litres of water we use every day?

All of the families we visited had a child with disability who is not going to school therefore not accessing the daily meal that schools provide to children. How can they survive then? What can a mother do to ensure her child has enough food? In one of the family we visited, the mother was not at home as she had left to go to beg a bit of food to the main city. She will come back maybe in 10 days with some food for a few days and then the father will go to do the same. 

This visit was really important for me and the team to understand the real situation of people and to develop an appropriate response.

I’ve asked Fred my Kenyan colleague to write on this blog and share his feelings from our visit; he said he will do it tomorrow.

It is Friday and a week I’ve been in Kenya, this afternoon we will travel to Eastern Kenya to visit one of our partners over the week end to gather more information about their situation.

I’m going there with Fred one of my colleagues from the Regional Office and a photographer. Yesterday I had a talk with Caro who is going to be with us for our visit and her story were very hard to listen. She was talking about persons with disabilities being ignored and neglected by their families and the community as they are not considered as “productive” but just as a person to feed.

Persons with disabilities have rights like anybody else to receive food and consideration. Caro is overseeing a community based program, she has great knowledge of people she worked with and our team will be able then to really understand and see the struggle of persons with disabilities in Eastern Kenya facing the drought and the food shortage. I’ll be out of internet access over the weekend so will not be able to blog but I’ll try to tell you the story of the visit next Monday.

I’m now in Kenya since last Friday and I have spent my time trying to understand the situation of our partners in facing the drought and the shortage of food. With my colleagues of the regional office we have met many people and quickly discovered that the situation was worst that we anticipated.

Yesterday, the UN has declared that some parts of Somalia have reached the emergency level of famine and the situation in countries around is not much better. It is in a way incredible that in the 21st century anywhere in the world people should face famine.

Most of us have never even felt really hungry and I can’t imagine how it is when you survive on less than a meal a day.

As we are trying to respond to this crisis we should also think of surrounding countries where people have not been able to cultivate their field because of lack of rain, where prices of basic food has increased by 3 to 4 times in a short period of time and where it becomes so difficult to even have a meal a day.

We’ve been working hard with very few hours of sleep during the last 2 days but it is worth as CBM is now raising funds and that we are able to participate to the effort to alleviate the suffering of people.

Friday went very fast with first meeting with the Kenya Red Cross and discussing how their emergency response could better include persons with disabilities. It was a very nice and productive discussion which will be continued on Monday with further meetings looking at how we could work together.

Saturday mid day we got the good surprise as we receive a very good draft proposal from one of our partners. We are right now working on putting it altogether. Fred my Kenyan colleague from the Regional office is today working in the office gathering very important information which will help us to move forward with developing the response strategy. It is always amazing to see people dedicated to their work giving extra time and providing essential support to the emergency response. More soon.
 

Friday, 15 July 2011 - Nairobi

I've landed in Nairobi this morning after my overnight flight from Brussels, and am now in a hotel waiting the team from Nairobi to pick me up to go to a meeting with the Kenyan Red Cross. I may not have first hand field info before beginning of next week as we are first meeting partners and reviewing the possibilities.

I’ll be taking a plane in few hours to go to Kenya to support CBM's Regional Office to assess the impact of food crisis in the Horn of Africa for people with disabilities and their families.

It is a crisis which started years ago but today it is very serious, our partners are not located in the worst affected areas but they already report children dropping from school as a result of the food crisis.

I do not really know my planning for the moment but I’m going there with the hope to ensure access for persons with disabilities - and especially children - to food distribution, clean water, health services, etc., as they should not be left out and should have the same chances as other to survive.

Our visit to this area has drawn to a close, and as we begin our journey I reflect on our time in this border town.

This area has a natural beauty, the community warm and welcoming. I have been touched by the strength of the people living in the interior despite experiencing a currently difficult period.  Even more so, the many people who have shared their lives with us particularly those living with disability.  I feel that we have a responsibility to stand alongside them during this time. And to work together as partners on the ground to ensure that whatever help is available reaches them quickly.

So pray for CBM as we respond to the situation in Kenya and horn of Africa countries, and work with partners including the Kenya Red Cross and others to bring help where it is needed.  Pray for the Emergency Response Unit headed by Valerie that they will find the support necessary to implement CBM’s response.  Pray for the people affected by the drought and famine that they will not lose hope, and that help will reach them quickly. And pray especially for persons with disabilities that are also affected by this drought, for their courage as they try to rebuild their lives in the following months and years.

Today at the hospital I met a few mothers and their children that had been admitted in the ward in order to receive supplemental feeding. Among them I spoke once more with Hawai, whom we had met two days before.  At that time she had just come into the hospital with her granddaughter, a two month old weighing 2.2 kgs on admission.

She had walked from the village of Elu, 3 kms away, worried for the baby’s health.  When the baby’s mother died while she was one month old, Hawai took on care of her granddaughter.  Due to the drought most of their cattle had died so there was no cow’s milk.  They tried feeding the baby on goat’s milk but she reacted after some time and started vomiting a lot. She was not well.  When the little baby was received at the hospital she was immediately put on supplements and milk resulting in a visible difference in just two days.

The Nursing Officer in Charge at Moyale District Hospital informed us that as a result of the current drought, despite feeding centres in the community, cases of malnutrition are on the rise.  This is affecting not only the children but the adults too. When children are discharged from hospital they are provided with food packages for supplemental feeding. These packages end up being utilized by the entire family due to the gravity of the situation.
However, it is encouraging to see how as in the case of Hawai’s granddaughter, necessary assistance can turn this situation around.

Driving through the villages close to the Kenya/Ethiopian border today reminded me of the words of a song 'In a dry and thirsty land where there is no water...' As we went from village to village the same scenario unfolded: thorny shrubs, depleted livestock, bare earth in which hardly anything grows, entire village dependent on food relief. Maize and sometimes beans and oil rations come once a month and are just barely enough to sustain the families.

People we spoke to told us they are down to one meal a day. From one family we heard the shocking words " yesterday, we borrowed food from our neighbours because our rations are exhausted. We will pay back when we receive our monthly ration of food supplies"

In these challenging conditions, coping for a person with disabilities has been even harder. We met several who shared their story with us. Adan, a 14 year old boy with cerebral palsy, Amina a shy beautiful 13 year old girl who is deaf. Rashid, 42 year old man with physical disabilities who told us this was the first time he could remember anyone coming to his village seeking out persons with disabilities.

Everyone is barely surviving and reliant on food rations. For those with a disability, they are doubly reliant, not just on food aid but on their family members and friend to help them access these food supplies.
Tomorrow the CBM team will be at the hospital to talk with the medical team.

I am on the border of northern Kenya and  southern Ethiopia at a town called Moyale. After visiting officials in the areas i went to the hospital. I was heartbroken when i walked into the room to see an elderly lady with a tiny child, a two months old showing sign of severe malnutrition.The Mother of the child died  when the baby was a month old leaving the baby with her grandmother.

We heard today that 75% of the population are affected by the drought and are needing food supplies. Workers at the hospital told us they have never seen it this bad.
Tomorrow  we go out to the community  to see how the drought is impacting people with disabilities.

Sunday, 24 July, 2011 - Kwale

Last week I was in Kwale District, and this morning I travel up to North Kenya.
The drought conditions that continue to ravage Horn of Africa countries resulting in a declared famine in Southern Somalia, is having a growing impact on Kenyan communities.

Almost 3 million Kenyans are currently affected.  This weekend the Government announced that this figure could rise significantly within the next few weeks if help doesn’t reach them quickly.  Traditionally non-arid areas in Central, Nyanza and Western are now experiencing food shortages brought on by the prevailing conditions.

CBM is concerned about persons with disabilities who tend to be more vulnerable in situations such as these. With already limited mobility they experience challenges accessing food distribution activities and moving away from harsh conditions to where help is available.
I hope to bring a daily update during our visit to Northern Kenya over the next few days.

CBM's Fredrick Njuguna reporting from the the Horn of Africa food crisis.

Sunday, 24 July, 2011, Meru - Tharaka

We travelled to Tharaka Meru over the weekend (23rd  of July, 2011) and from what I saw in Tharaka, this is the worst  food crisis ever to happen in Kenya.

It was so sad meeting families with children with disabilities, majority depending on their single mothers, being in such a desperate situation.  Families that had not had meal for days, others depending on a cup of porridge from the grains received from well wishers if lucky.

I felt sorry for the women who had to walk hundreds of kilometers, despite the insecurity and uncertainty, to beg for food  to feed their families; women who had to walk 3- 4hrs to fetch water; children who were 1- 2 years old and have not access to milk since their mother stopped breastfeeding them Though the government is trying to provide some food ratio through schools, children with disabilities and the non schooling children can not access this food and are showing signs of malnutrition.

We met  the family of Lucy  Makena, a single  mother, with five children two of whom aged 4 years old have cerebral palsy (cp).  She is leaving in a small rented house of Kenya and trying to sell fire wood - which no one has money to buy - to feed and pay rent. One of the girls (Caroline) with CP was abandoned in the forest and was rescued and she agreed to take care of her after being promised to receive rations from the children department and government,promises which have never materialised. Many are the times they have slept hungry and she got to a point of considering  abandoning all the children and run away.

Another family with 5 children, one of whom had multiple disabilities, had no food at all and had put two stones in a cooking pot as symbol of an upcoming meal.

The situation in Tharaka and other parts of the Northern Kenya needs urgent intervention to avert deaths.

We are now at the closing session of the official part of the conference. I was sitting in the Panel Discussion which was discussing the subject 'From Disaster to Development'. There were good recommendations and discussions, however the question is always "How is all this positive willingness and attitudes going to be translated into action?"

I feel that the key point raised by Jan Engeland, a former Humanitarian Coordinator, to bring disability at operational level and provide key tips, elements and guidelines on the spot of an emergency is the solution. I also would like again to highlight that emergencies are opportunities for better inclusive development and also that Inclusive Disaster Risk Reduction participates to overall poverty reduction by providing better opportunities for people with disabilities to participate.

I'm really happy about the conference and will post the conclusions as soon as they will be available.

Atif Sheik representing the DPO (Disabled Persons' Organisation) Special Talents Exchanges program, from Pakistan is talking about their work in trying to get the Cluster system to listen to them after the earthquake in 2005 in Pakistan. Through this process they achieved a lot such as training World Vision, Pakistan Red Crescent , Unicef, local media, etc. field staff on how to include disabilities.

At that time they also published a disability checklist which give basic advises on how to make relief accessible to persons with disabilities.

Since then they’ve continuously been involved in Cluster work and advocacy. Last year following the floods they set up the Aging and Disability Task force regrouping local DPOs and international organizations working on Disability or Senior issues.

Leonard Zulu, Head of the Global Protection Cluster support Cell, IASC, insists in his presentation that disability being a crosscutting issues should be integrated in each and every aspect of the humanitarian protection cluster response.
UNHCR as a leading protection agency has taken a key role by raising awareness on inclusion of persons with disability rights in global humanitarian protection through the adoption of a special conclusion related to persons with disabilities. This conclusion is a very important advocacy document as it also includes standards and recommend specific measures, for instance ensuring registration of persons with disability, ensuring services are accessible, training on dignity, rights and participation of persons with disabilities. This conclusion leads to the publication of a guidance note on how to include persons with disability in emergency with the objective of ensure full participation and removing all form of discrimination towards disability.

This guidance note will be presented to the Inter Agency Standing Committee for adoption across the different clusters and humanitarian reform.

Hazel Jones, from Water, Engineering and Development Centre at Loughborough University in UK is explaining to the room how to make water and sanitation accessible to persons with disability in emergency situation. She demonstrates how persons with disability can help the young expatriate engineers working to bring a community safe water and minimum sanitation. There is a need to build up common languages and understanding and to ensure that locally persons with disabilities take an active role in making water points accessible.

This morning starts with a speech from the Norwegian Minister of Children, Equality and Social inclusion, Mr. Audun Lysbakken. His talk focuses on universal design and accessibility.

Consideration of all and inclusion for all is a key element, he said that this should be mandatory principle before government allocate funding to humanitarian project and he stressed that this should be feasible as there are existing solutions.

Children also need to be reached and cited the UNHCR conclusion saying that children with disability are particularly at risk therefore access to protection measures is very important. He is convinced that Norway as valuable experiences which could be transferred to international cooperation.

The first day of the conference is now over, I feel happy as we had many good presentations, voices from people with disabilities and learnt about innovative approaches.

It is refreshing to see how much people are committed to disability issues in emergencies, but it also highlighted challenges that we still need to address.

Our colleague from Japan was raising the question on how to support people with psychiatric disability or mentally challenged in temporary communal shelters, and the response was a heavy silence from the panellists but also from the all room... This highlights the gaps that we still need to fill, the barriers that we have to remove and the lack of good practices in certain field or the lack of disseminations.
 
I'm now really looking forward to listen tomorrow and get new opportunities to learn from my colleagues and peers, very exciting time!

CBM Partner CDD from Bangladesh introduces the Inclusive Disaster risk reduction project, providing clear steps to ensure that persons with disabilities are part of the initiatives. This demonstration is built on the fact that in previous disasters, cattle were saved before persons with disabilities. Preparedness has now become a key element of ensure that persons with disabilities are rescued in time of disasters.

Mosharaf Hossain, Bangladesh Country Director for Action for Disability in Development (ADD) presents their response to Cyclone Sidr in Bangladesh and stressed the importance of including DPOs (Disabled Persons' Organisations) in the relief phase, but also to ensure that it bridges the lack of capacities of humanitarian stakeholders to address the needs of persons with disabilities.

As recommendations they emphasise on:

• Donor commitment to inclusive  approach
• Data gathering and counting persons with disabilities
• Participating to coordination mechanisms

Lyn Lusi from our partner Heal Africa is talking about Gender based Violence and Disability. She is given us testimony of women with disability having been victims of rape. This is very touching and the room is silently listening to this very powerful words showing how being a disabled women increased the risk of abuses.

What can be changed to improve the situation?

Setting up a system approach  with 'components':
1 fight poverty and ensure education
2 provide accessible medical treatment
3 Promote Gender Justice
4 to ensure that HIV programmes are implemented including people with disabilities

It is also key to ensure that the community at large are involved in  resolving conflict and addressing Gender Based Violence; that the community is involved in challenging long term rooted practices on attitudes towards Women and Persons with disabilities.

Ola Abu Alghaib from 'Star of Hope' in Palestine is a wheelchair user. She explained us how the conflict has impacted her life. She shared with the conference how because she had no permission to leave the West Bank she could not reach specialised hospital to deliver her first baby. She could not access appropriate services and in the hospital she went in Ramallah no one knew how to help her, a woman with disability, to deliver.

Norwegian Red Cross President : Sven Molekleiv
It must be a humanitarian imperative to have people with disability at the centre of the humanitarian response.
Persons with disability should participate and be considered as a resource and active contributor to the humanitarian responses they have expertise that we should consider and value.

Mr. Jonas Gahr Støre, the Norwegian Minister of Foreign Affairs, stressed 5 key elements to better ensure inclusion of disability issues in his opening speech:

1. Participation of victims in planning but DPOs (Disabled Persons' Organisations) can’t be alone and government needs also to include them
2. Prevention - we need increased focus to protect civilians during conflict and ensure that Geneva Convention are respected
3. Victim assistance should be included in all the weapon legal instrument as it has been done in landmines and cluster munitions treaties
4. Victim assistance is not about medical care and rehabilitation but it is also social and economic inclusion
5. As a summary we need to lift new voices at the central stage... open door to new groups and empower pressure groups;

The conference is now opening , the room is full and it is great to see it.

Ann-Marit Sæbønes, Special advisor to the UN Special Rapporteur on Disability and Liv Arum just finished the opening speech. Both of them stressed that persons with disabilities are the largest group of vulnerable people in the world and yet are excluded from humanitarian work, it is time that this changes and this conference will set the tone.

I arrived this afternoon in Oslo and went straight to the conference room. There will be more than 100 participants coming from all around the world.

Together with Atlas Alliance staff we've set up the pictures exhibition that I've taken with me from Brussels and which shows inclusion in Haiti emergency response. It looks great and once again I'm really proud of the work our partners together with us have achieved in Haiti.

7 pm, a bus drove us to the 'Gamle Logen' (don't ask me what it means as no one could translate it to me) for the reception hosted by the Norwegian Ministry of Foreign Affairs. We enter in a ballroom with crystal lights and red carpet.. what a reception for all people coming from around the world!

I'm very happy as about one third of the participants are persons with disabilities and are going to bring in their experience and expertise, it looks promising and refreshing!

It is always so good to meet so many old friends from around the world with so diverse experiences and so much to say... Michel Pean, state secretary for inclusion of persons with disability in Haiti, Lyn Lusi in DRC representing Heal Africa a long standing CBM partner, The Leprosy Mission International from Myanmar and the head of the disability and social welfare of the same country, Atif from Pakistan, Ola from Palestine, Noman from Bangladesh and so many others... so good to hear all their stories and successes and so motivating to be able to bring them together... I love it and I know already that these 3 days will lead to a new perspective for inclusive disaster management...

From Brian Hatchell

What a difference 45 minutes can make.

When I woke up this morning I was in Port au Prince, a city still struggling to rebuild after a massive earthquake 10 months ago and now caught up in the grips of a cholera outbreak.

As I write this I’m sitting in an airport lounge in the Dominican Republic enjoying a cappuccino, some melodic Caribbean music and the entertaining conversations of tourists depressed by the thought of returning home. Haiti and the Dominican Republic may share the same island, but they are worlds apart.

The January 12 earthquake devastated Haiti, a country already suffering from endemic poverty, political instability, and a struggling economy. While the Dominican Republic, a country with a booming tourist industry, stable government, and bright future, was untouched.

Before my trip to Haiti I read a plethora of articles critical of the rebuilding effort to date. They criticized aid agencies for not doing enough, accused the local government of corruption, and blamed the international community for not delivering on financial promises.

Once in Haiti that same sentiment was echoed by many local residents and even some internationals. While I realize not everyone is content with the current state of affairs in Haiti, and there is a long way to go, I must admit I’m a little surprised.

When I arrived in Haiti I was expecting the worst, but was surprised at the level of rehabilitation.

Let’s put things into perspective. 10 months ago a massive quake struck just outside Port au Prince destroying the economic capital of the country, decimating the political infrastructure, crippling the country’s main air and sea port, killing an estimated 300,000 people and displacing another 1.3 million.

Have we not learned anything from Katrina and the Indian Ocean Tsunami?

Recovering from such a massive disaster takes time, despite the best intentions of everyone involved. You can’t simply throw money at a problem and hope to solve it overnight.

Katrina struck Louisiana in August of 2005. The United States has all the financial backing, political will and professional expertise you could want to throw at a problem. Yet five years later they are still dealing with the impact of Katrina.

11 Countries were impacted by the Indian Ocean Tsunami, the largest humanitarian disaster in the history of the world to that point, and it took a five year commitment by the international community to rebuild many of the hardest hit countries.

Why then are we surprised 10 months later to still see a city in ruins and millions living in tents in a country considered the poorest in the Western Hemisphere?

I’m not saying things couldn’t be better, they can always be better. But just for a moment think what it would be like if London, New York, Berlin, or any major capital was crippled by a disaster. Would the recovery effort have been more swift?

According to the Government of Haiti the country lost 60 per cent of its government, administrative and economic infrastructure, and the quake reduced the country’s GDP by 70 per cent.

The recovery effort in Haiti is going to take years. I’ve heard estimates anywhere from five years to ten years or even longer.

But there is one thing Haiti has to build on, its people.

During my time in Haiti, and I haven’t been there long, I have been completely blown away by the resilience and strength of its residents both young and old.

These are people that have lived through hardship many of us will never know. Just two years ago they lived through four hurricanes in less than two months. They have lived through political instability and forged their own futures. They always find a way to persevere regardless of their circumstance, mainly because many of them don’t have a choice.

It’s easy to criticize and say things should be different, they should be. But it takes time to rebuild after a disaster, again, just look at Louisiana.

Instead of taking the easy way out and criticizing the efforts, maybe we should take a moment to recognize the positive steps that have been made.

I have met many people, young and old, whose lives were decimated by the quake, and yet with help from those in the humanitarian sector they are getting their lives back together.

I can think of a smiling Rodenson who wanted to be a football star, and is now learning how to play the sport with one foot because he put his sister’s life ahead of his own.  

I can think of Magolie who lost four nieces and nephews in the disaster, one of them on her chest while she lay in the ruins. She is rebuilding her life one day at a time thanks to counselling.

I can think of Washline who some thought would lose her leg or perhaps never walk again, running around the corner to meet me.

And I can think of Sebastian who lost his right leg but still plays football with the boys in his tent city on a daily basis, and the list goes on.

All of these people would like a better life. They all deserve a better life. But they aren’t complaining because they don’t have one. They are working hard to improve their lives and are simply asking for some help to do so. They can do it on their own but might need a little help. Who among us doesn’t?

Don’t get me wrong, I know Haiti has a long, long way to go, and even after years of rebuilding the countries future may not be any brighter than its past.       

But if we measure success by the reconstruction of physical structures we will never be happy.

Instead if we chose to measure success by the rebuilding of the human spirit and the lives and livelihoods of those we seek to help, perhaps for a moment we will see that even though so much still has to be done, so much has already been accomplished.

We need to realise that the success of Haiti is not dependent on the rebuilding of structures by the international community. Haiti will be physically rebuilt by Haitians. We need to realise our role is to support the residents of Haiti anyway we can, and to celebrate their successes, not our own.

From Brian Hatchell

Yesterday I visited an unbelievably inspiring programme called Pazapa, which means ‘step by step’ in Creole.

Pazapa is primarily an education centre for about 225 children with disabilities, but in reality it is so much more. It offers nutrition and health care services, family planning, clubfoot and orthopaedic care, community outreach programmes, income generation training, training/education for parents of children with disabilities, rehabilitation, vocational training for older students, sign-language classes for the hearing impaired and home visits for parents and children who can’t attend the school.

Hard to imagine all this is taking place in a facility located on a piece of land about the size of a football field, and housing four open-air classrooms, a kitchen and two administration tents.

Overseeing it all is a woman by the name of Marika MacRae, a woman with a heart the size of Haiti, and the strength of a lioness. Marika was born in Fergus, Ontario, a small farming community north-west of Toronto, but her parents moved to Haiti when she was only three months old. They took over the project from a group of Peace Corps volunteers and eventually Marika took it over from them. She walks around the grounds like a mother amongst her flock, and the children run to her simple to walk alongside her or hold her hand.

The children are incredible, ranging in age from newborn to 24 years old. Never have I seen so many smiling faces. Almost as soon as we show up they come running over to us and grab our hands and start talking with us, or inviting us to play, or grabbing our hand and walking us around the playground. It’s a true joy to be among them. To clap and dance, to swing a rope, to kick a football, or just to sit and stare at each other. Communication seems easy despite the many barriers. Almost makes it seems like words are over-rated. I prefer the smiles, hand-gestures and laughter.

I met a woman, Leon Isador, whose two year old son Leonel is in the early intervention programme for children with intellectual disabilities. Leonel has trouble standing and walking and cannot communicate like other children his age. Leon has three children, her house was destroyed in the quake and she and her husband are struggling to make ends meet. When I asked her what Pazapa means to her she smiles and says Pazapa is supporting the entire family. I ask her to explain and she tells me that Leonel has a place to come and play with other children, receive physiotherapy, and she receives training on caring for a child with a disability. But that’s not all. She explains that she is part of Pazapa’s livelihood programme. She, and a number of other women, are currently making peanut butter and jam that they plan to sell in Jacmel to earn an income.

In every way, shape and form Pazapa is truly living up to its name for Leon and her family. The organization is walking alongside her family during their journey ‘step by step.’ Pazapa isn’t going to solve all their problems, but it is reducing some of the stresses in their life, offering assistance where they can, and support when it is needed.      

In return, CBM is supporting Pazapa but helping with the daily operation costs, and along with a couple other agencies, will help build a new centre in the New Year. Money wisely invested.  

We had planned to spend about a couple hours at Pazapa, but ended up spending half a day. When it was time to leave it was genuinely difficult to tear ourselves away. I could have spent all day playing paddy-cake with the kids and signing with some of the students.

Pazapa is a great example of a grass-roots intervention. Find a need, meet it, repeat.

The idea of inclusion is foreign to Haiti. Children and people with disability in general are not included in the mainstream of society. They are often pushed to the background and hidden within households. CBM is advocating for inclusion in education, the workplace, society and life in general in Haiti. But until the happens it’s important to support organizations like Pazapa so children have a safe environment to learn and play and their parents get the support they need to take care of their children and life a fruitful life.

From Brian Hatchell

Spent the day today driving around Port au Prince, Carrefour and Criox des Mission visiting camps and trying to determine what impact Tomas has on those living in tents or located near the seaside.

I must admit, in many cases, if you didn't know a Hurricane had passed through the area, you would never have suspected. There was hardly any water in some of the lower lying areas we initially thought would resemble a swamp. And many other areas we thought might suffer severe wind damage, showed no signs of any disturbance what-so-ever. We even joked amongst ourselves in the car asking it if even rained in these areas.

What an answer to prayer. We were so worried when we headed out this morning tha we would find camps in disarray, people clinging to what few possessions they had left, mud and swamp-like conditions everywhere, and people in desperate need of assistance, but we couldn't have been more wrong, and boy were we pleased.

Many of our staff spent the day on the phone touching base with our beneficiaries and making sure they were ok and asking if they needed anything. Only a handful of people asked for assistance. So we caught up with our communities workers and visited some of those who asked for assistance just to get a gauge of how Tomas impacted them. Most were simply in need of a little medical attention completely unrelated to Tomas. One young lady recently had a below the knee amputation and simply needed her dressing changed, but since the local hospital and our community health programme were both shut down she had no where to go. Another couple were elderly patients that hadn't been heard from since Thursday so family wanted us to stop by to make sure they were ok, and they were.

All day long we kept commenting on what little direct impact the storm had left. There wasn't even flooding in some of the areas that are flooded when it doesn't even rain. Unbelievable.

Of course there were stories of devastation. Leogane, southwest of Port au Prince seemed to suffer the brunt of Tomas. Landslides, flooding and six fatalities. The road to Jacmel in the south was cut off by landslides and flooding and they were apparently still experiencing high winds today, and Gonaives in the northwest also was hit pretty hard with flooding.

So Tomas left its mark on parts of Haiti. But the big fear that the camps would be hammered with high winds and flooding and devastate and already devastated 1.3 million people never materialized.

What a blessing for a country and a people who have already suffered enough.

I was joking with our translator, Frantz, today that the residents of Haiti will be glad to celebrate New Years Eve this year. They will be glad to see 2010 pass. He laughed and said that night can't come soon enough.

Read more news about CBM in Haiti here.

From Brian Hatchell

It appears the worst is over, and it may not have been as bad as anticipated.

As of 8 pm tonight most tracking maps show the eye of Tomas has passed north of Haiti and is moving towards the Bahamas and Turks and Caicos.

We certainly received a lot of rain over the last 24 hours, but thank goodness it wasn't as heavy as we feared, at least not in Port au Prince.

However, that isn't the case in other locations around Haiti. According to early local news reports there was heavy flooding in Leogane to the south and west of Port au Prince. I've seen some pictures of people wading through waist high water trying to get to secure locations.

Early indications are that at least four people lost their lives due to the flooding. Hopefully this number won't increase throughout the weekend as we hear more from some of the isolated communities throughout the country.

The good news the heavy winds, which were feared, did not materialize in and around the numerous camps in Port au Prince. With 1.3 million earthquake survivors living in tents it could have been a nightmare if Port au Prince sustained a direct hit or if strong winds had swept through the capital.

At least for now it appears that didn't happen, but we won't know for sure until tomorrow morning when we venture out into the communities to check on the camps and their residents.
Even if the camps didn't get hit by wind, they are certain to be a mess from the constant rain. Even when we get normal rainfall the camps resemble a swamp for days afterwards.

It's really hard to look on the bright side. I know it could have been much worse, but I can't help thinking of Rodenson, Sebastian, or Washline all huddled in their tents riding out the storm. Watching the water flowing through their tents and wondering when it will end. Only to be left with a muddy swamp on their doorstep.

I bet the residents of Haiti thought things couldn't get much worse than 2008 when they were hit by four hurricanes in less than two month. But somehow 2010 has been an earthquake, a cholera outbreak and now Tomas. I think that's enough. These people deserve a break, don't you think?

From Brian Hatchell

I woke up before the sun this morning in order to get an early start on the day, but as it turned out the sun never made an appearance at all.

Most mornings in Haiti are filled with blue sky and plenty of sunshine, a constant reminder of the fact you are in the tropics. But today there was no blue sky, no sunshine, only the feeling something ominous was on the way.

Talk of Tomas dominated every conversation I had or overheard today. The thick, dark billowy clouds overhead were a constant reminder that this was no ordinary day.

The morning brought good news. Tomas appeared to have veered west and would likely pass directly between Jamaica and Haiti, but strong winds and rain may still be in the forecast for the next two days.

Despite the apparent reprieve the Government of Haiti and he international humanitarian community, including CBM, weren't about to take any chances. Most of the day was spent making sure people in tent camps located along the waterfront were moved to more secure locations inland. 

As we drove through town around noon we could see people loading up vehicles or packing items into buildings along the main roads. It seemed like everyone was 'battening down the hatches' and preparing to wait out Tomas.    

According to the lastest storm tracker maps people were even talking about the possibility the wind and rain might pass Port au Prince by altogether. But by three o'clock it started. Lightly at first, almost like a Spring sunshower, then heavier and constant.

As I write this it's been raining steady now for more than five hours. No wind yet, just steady rain. Once again my thoughts and prayers are with those living in the tents. I only hope as many as possible were able to get to dryer, more secure locations.

Last night during dinner Pierre, the owner of our guesthouse, told us something interesting. He said he can remember as a child his mother and grand-mother calling Haiti, Haiti-Tomas. I asked one of our translators about it today and he confirmed it. In fact Leeox said many people still refer to it as Haiti-Tomas, although he wasn't exactly sure why. But he did say that they only used the hyphenated name when they were speaking ill of they country. Almost like a parent who is angry at a child and calls them by their full name.

Pierre said that is why many Haitians didn't fear Tomas or its impact. They see the storm as almost human. Pierre said 'Tomas is simply coming by for a visit, and won't stay long.' I asked him if he would do much damage and he said 'Depends how happy he is to be home.'

Well, Tomas hasn't arrived home just yet. He's expected to pass west of Haiti sometime after 7 am local time Friday. I guess we'll just have to wait to see what kind of mood the 'prodigal' is in.

From Brian Hatchell

Just over a week ago I wrote a blog voicing my disbelief that after everything the residents of have already been through they were now facing a cholera outbreak. I couldn’t believe that things could worse. Well once again I am wrong, apparently they can get worse. There is a possibility that Hurricane Tomas may swing through this already decimated country, and even if it doesn’t pass directly overhead, it is sure to push some wind and rain in this direction. Not exactly the kind of news you want to hear if you live in a tent on an island in the middle of the Caribbean as say, oh, 1.3 million Haitians currently do.
 
According to the Government of Haiti the country is in the trajectory of Hurricane Tomas, which is expected to impact Haiti this Friday (Nov 5) with strong winds and rain for several days. The government has activated its hurricane contingency plans nationwide and is urging people to move into safe houses of friends and relatives. Only problem is, not everyone has friends and relatives with safe houses they can bunk with.
 
There was a small storm that passed through Haiti several weeks ago and it served notice as to how vulnerable tent dwellings can be in the face of strong winds. As I travelled through some tent cities over the weekend I saw people trying to fortify their homes as best they could. Many were constructing heavier wooden frames for their tents and securing the poles with rope and spikes into the ground. However, many others still don’t have adequate tents and are simply living under a bunch of tarps strung together with whatever they can find.
 
In preparation for Tomas the government is pre-positioning additional shelter materials and food stocks in key locations along the coastline. They are even preparing barges to move cargo along the coast if roads are rendered inaccessible by the storm.
 
The 1.3 million people living in more than 1,300 camps throughout Port au Prince are highly vulnerable to any weather-related events and everyone, the government, the UN and local and international aid agencies are doing all they can to prepare for the possibility of storm damage.
 
Ironically, all this is happening amid a two day national holiday in Haiti. All Saints Day yesterday, and The Day of the Dead today. Many people are marking these days by attending church and praying for a reprieve from Tomas. Others are taking the opportunity to celebrate before they ‘batten down the hatches.’ However the majority appear to be doing whatever they can to prepare, stock piling food, fuel and supplies, removing any lose debris from around their homes, and making sure their doors and windows secure properly.
 
I haven’t seen anyone boarding up their windows yet, but we still have a couple days.
 
It’s odd though, when I chat with local residents no one seems the least bit worried about Tomas. They seem to take it all in stride. When I ask a local colleague why, he simply says ‘we’re used to it, it’s part of life in Haiti.’
 
This country has been through so much, political strife, endemic poverty, natural disasters, outbreaks of disease and now a potential hurricane. Yet, as I saw today, they still find the time to dance in the streets and celebrate a national holiday.
 
It’s not that they don’t care about Tomas, everyone is aware of the potential threat, it’s just that they have time to celebrate life before worrying about tomorrow.
 
We often hear the phrase ‘don’t worry about tomorrow, for today has enough worries of its own.’ I find that an extremely hard lesson to apply. I’m always stepping into tomorrow, worrying about what’s around the corner. But perhaps Haitians have the right idea, celebrate today, the gift we have been given now, for we don’t know ‘what’s next.’

From Brian Hatchell

I spent the morning watching a group of young boys playing football under a clear blue sky. What a beautiful image. The smiles on their faces. The laughter in the air. The endless singing and dancing whenever one of their shots found its mark. It was clearly evident these boys were enjoying themselves, probably imagining they were playing for Brazil or Argentina and scoring the winning goal in the World Cup. It was a scene I’m sure was being played out on a million pitches the world over. The only difference here is the setting.
 
These boys were playing amid the garbage strewn across a patch of ground in one of the numerous tent cities scattered throughout Port au Prince. The camp itself is located on the water’s edge in Carrefour, a suburb of Port au Prince. The pitch, if you can call it that, has blue and white tents and rows of ‘porta-potties’  on one side, and the Caribbean Sea dotted with ocean liners laden down with supplies awaiting access to the main port on the other. A couple rocks served as goal posts, and I and a couple other onlookers sat on simple cinder blocks cheering them on.
 
I would love to say I happened upon this scene by coincidence, but that wasn’t the case. I had come specifically to see one boy play – Sebastian. This is the nine year boy who lost his mother, and the lower part of his right leg when a wall of his home fell on him during the earthquake. Sebastian is now living with his aunt and three cousins in a small tent in this camp. It has been their home now for almost 10 months, and will probably continue to be their home for the next 10 months or longer.
 
But today, the setting didn’t matter. Their circumstances didn’t matter. Today, they were just a bunch of boys having fun playing football like most nine and ten year olds do, and so was Sebastian.

There he was amongst the throng of boys chasing the ball across the pitch. Laughing and giggling with his mates. It didn’t matter he wasn’t as quick or agile as the rest of them, they went out of their way to make sure the ball ended up on his foot and he had a chance to score a goal and live his dream just like the rest of them.
 
It’s easy sometimes in the heat of competition, any competition, even a simple game of pick-up, to get caught up in winning. But here were a bunch of kids that seemed to get more enjoyment out of seeing one of their friends playing alongside them. Playing a game which, at one time, many people including Sebastian himself, thought he would never play again. It wasn’t about winning or losing. It was simply about having fun, and being one of the boys. But as simple as that sounds, that only works if everyone is on the same page.
 
Today, on this garbage strewn patch of dirt, amid a sea of blue and white tents, located on the edge of the Caribbean in a city decimated by an earthquake, here were a bunch of kids putting friendship and love ahead of anything else. Showing their brother that he isn’t any different than they are. He too can play this beloved sport and dream of scoring the winning goal in the World Cup just like them.
 
When all was said and done and the game was over, the players dispersed to their respective tents and Sebastian came up to me and Leeox, my translator, and said ‘did you see me, did you see me score that goal?’ Of course we did, and what a goal it was, the first of many more to come.
 
As we walked Sebastian back to his tent to say goodbye, it dawned on me, we often think life is defined by the major moments in life, but I’m not so sure that’s entirely true. Sometimes, I’m beginning to think, life can be defined by the almost insignificant, fleeting moments that go relatively unnoticed.
 
A simply game of football played out of sight of almost everyone for a matter of a few moments can help someone, like Sebastian, realise he is capable of anything regardless of his disability. That realisation, garnered through one fleeting moment, is far more valuable than any words spoken by his parents, teachers or physiotherapists.
 
I would like to think we all strive to do our part to make the world a better place. We engage in philosophical debates, we draft lengthy policy papers, we hold international meetings in far off lands, and all of that is necessary to change current practices.
 
But sometimes it isn’t about words, it’s simply about actions. Striking up a football match and inviting someone with a disability to play and giving him the same opportunity kick, pass and shoot the ball like everyone else is a living breathing testament to the idea of inclusion.  
 
Today a group of young boys living in an tent city in Port au Prince have shown me that sometimes, actions speak louder than words and their impact can be even greater.

From Brian Hatchell

Today I spent the day in the presence of a true hero - a nine year old boy named Rodenson. He taught me that a hero is not determined by their actions, but by their character; this young boy has strength of character beyond his years.

When I arrived at the tent city his family now calls home I wasn’t sure what to expect when I poked my head into the entrance, in fact, I had prepared for the worst. But when I did, I was greeted by one of the biggest smiles I have ever seen.

There was Rodenson, lying belly down on a mattress, eating his lunch, and looking up at us with his huge brown eyes and a smile from ear to ear.

It may not seem like much, but that smile spoke volumes.

Back on January 12 Rodenson and his three siblings were playing in their house when the earthquake struck. Almost on instinct they bolted for the door, but once outside Rodenson realized his four year old sister Anne was still in the house. Without a thought, without a moment’s hesitation, he ran back in to get her. As the two of them were fleeing a wall of the house fell on Rodenson, trapping him, but Anne was able to escape.

That moment of heroism saved his sisters life, but cost Rodenson his right foot. Some might say not a heavy price, but to a young boy who dreamed of becoming a football star it was the end of his dream, the end of his life.

Immediately after the amputation his mother – Caroline - says Rodenson lost his spark. The boy who couldn’t stop laughing, smiling and playing no longer laughed, no longer smiled, and no longer played, and she wondered if he ever would again.

The prospects for the family didn’t look good either. The father was killed in the quake, the family house was destroyed, and Caroline’s cosmetic business lay in ruins. With no home and no income the family of seven (including an uncle and a grandmother) were forced to live out of the back of a pick-up truck for six months, with no hope of a future.

It was a difficult time for the family, but even more so for Rodenson. Caroline says he was angry because he could never play football again, he was worried people would make fun of him and he feared other children would pick on him.

But soon after the amputation Rodenson attended a Child Day Care Centre run by CBM and our local partner CES. At the centre Rodenson had the chance to play, sing, draw, and basically just be a kid again. Caroline took him as often as she could and says while it took time, the son she thought she had lost eventually returned.

When I saw him today, he was like a different boy, smiling from ear to ear and laughing and playing to the camera.

After a brief conversation we presented him with a brand new football. He immediately jumped off the bed, strapped on a temporary stump-cover and literally ran outside, with no crutches, to start playing football with his older brother.

The rest of the morning he spent running around the tent city and playing to the camera.

When his sister Anne returned from school, the two of them were inseparable.
It’s quite clear by watching them together that his single act of heroism encompassed his love for her, and now her every action encompasses her gratitude.

When a street vendor strolls by selling ‘freezies’ she asks for one and we oblige, but she immediately takes it inside the tent to Rodenson, so we buy another. According to her mother she seldom leaves his side, and when he does run on ahead she can be heard yelling out ‘Short Foot’ hoping he will slow down so she can catch up. A nickname only a sister could get away with. 

The family still has a long way to go. They were able to move out of the pick-up and into a tent, but the mother is still unemployed and three of her four children are not in school. There is no hope of rebuilding the family house, or restarting the family business, and who knows when the kids will return to their studies.

But that doesn’t seem to bother Caroline. She openly says she doesn’t know what the future holds for any of them. She simply smiles, turns her palms up and says it’s all in God’s hands now; there is nothing else I can do.

She sits on an army cot in the stifling midday sun and watches her two youngest children play amid the multitude of tents. Despite her circumstances Caroline appears quite happy, and why not. Her only daughter is alive, and the son she thought she had lost forever has returned. 

From Brian Hatchell

It's been a crazy couple of days in Haiti. All anyone is talking about is the recent cholera outbreak in the northern part of the country - Artibonite region - about 100 kms north of Port au Prince.

As of Sunday 250 people had succumbed to the illness and 3,000 others were affected.

No matter where you go and who you talk too 'cholera' was the topic on eveyone's lips.

In a country still reeling from the effects of the January 12 earthquake, this is the last thing anyone wanted or expected. A cholera outbreak was feared in the weeks after the quake, but no one I spoke too says they thought it would happen now.

It makes you wonder, how much can a people endure, when will the suffering end?

While the response has been swift, only time will tell if it was effective enough to contain the outbreak.

The worry is that it could head south and threaten the millions of people living in tents throughout Port au Prince. If that happens, it could be devastating.

From our guesthouse we can hear people worshipping in a church close by. The Sunday service starts at around 6 am and runs until well into the evening. I can only imagine how many prayers are being offered up to help those already dealing with the outbreak, and for it to be contained.

While I don't personally fear the impact of an outbreak, even in Port au Prince, I pray God will spare these people, who have endured far too much already, another devastating disaster.

From Brian Hatchell

When I was planning my return trip to Haiti there were a couple of people I was desperately hoping to reunite with – Stefan and Fara.

While I know CBM has done some incredible work with thousands of quake survivors over the last 10 months, each of whom has their own heart wrenching story, it was the story of Stefan and Fara that stuck with me since the day I met the pair at the Adventist Hospital.

Stefan was a three year old boy who was at risk of losing the lower part of his right leg. He had broken it during the quake and an infection had set in. Doctors felt there would be no option but to amputate because his bones would never support his weight.

Fara was his 10 year old sister and surrogate mother. She lived with Stefan in the hospital for seven months while her mother stayed at home to look after her three other children. Fara took care of Stefan’s every need, she bathed him, changed him, fed him and wheeled him around the hospital so he could hang out with the other kids. She even slept on the cold, dirty floor beneath Stefan’s crib. For seven months she put her life on hold to take care of her brother. She struck me as an incredibly selfless child.

When I left Haiti I was certain the next time I saw Stefan he would have a prosthesis. Thankfully I was wrong.

When I entered the courtyard of the family home I immediately saw Fara and was blown away by how grown up she looked. She is now 11, a young girl, but when you look into her eyes you can tell she is much older.

It didn’t take long before the courtyard was full of children from all over the neighbourhood. But as I scanned their faces I couldn’t see Stefan. When we asked where he was, his mother, Marie Therise, said he is out playing with friends and sent someone to get him.

While we waited I was amazed at how old Fara seemed now. She sat there quietly listening to us talk, and thinking before answering our questions. She seemed quiet, almost reserved.

When Stefan walked through the gate it was clear he wasn’t happy that we forced him to cut his play time short. When asked, he said he recognised me from before but didn’t want to talk. He ran past us into the house. I wasn’t really upset. The mere fact he could run into the house was a miracle.

Here was a boy who only six months ago had a serious leg infection, needed an external fixator to keep his leg from breaking - a third time - and was at risk of having it amputated. In fact, on several occasions the doctors had given up hope of recovery and were on the verge of amputating it. The only reason they didn’t was because of the dogged determination of a CBM physiotherapist who kept pleading with them to clean out the wound and keep increasing the medication.

Marie Therise says if it wasn’t for the physio Stefan would have lost his leg and his life would have been completely different. When asked if she was glad to have the pair home she said she wakes up every morning and thanks God they are back home with her.

When it looks like Stefan has finally forgiven me he comes back outside and just leans against the wall watching me. When I ask if he is happy to be home he just stares at me and shakes his head up and down, like a teenager trying to be cool. But when I ask him what he hopes for, he quickly stands up and says a little yellow car. There is a little boy in there after all.

When I ask Fara if she is glad to be home she says she as happy to be able to help her parents out by taking care of Stefan but she didn’t like living at the hospital with all those sick people. She says it’s better to spend the days playing with her friends and just hanging out, gossiping about boys and having fun.

Neither of the kids are in school because the parents can’t afford the fees. But Fara says she goes to a kids group everyday and learns how to make bracelets and crafts.

If you didn’t know it you would never think these kids have been through any kind of trauma. They seem so normal. But I know different, I know they have been through something incredible and they appear to have come out the other side no worse off.

Marie Therise says the experience has brought Stefan and Fara closer together. She says they are bonded for life. You never see one without the other and they are always looking out for each other. When asked what her hope is for the future Marie Therise says, "I hope that the way God healed Stefan He will heal our family and the entire country. I hope my children will return to school and grow up to realise their dreams.” The prayer of all mothers.

It’s incredible when you realise the magnitude of what these two kids have been through. But it pales in comparison to their resilience. Life has dealt them a tough hand, but you know just by looking at them they will be okay. They will make the most of their opportunities in life and they will do so together.  

From Brian Hatchell

What a day of highs and lows.

Our plan today was to drive out to Carrefour, a suburb of Port au Prince,  and visit a couple of children who CBM helped early on in our emergency response to see how they are doing. Driving anywhere in Port au Prince can be a nightmare. The roads are rough, extremely bumpy and packed with motorbikes, cars and trucks. In fact, if possible I think that is one thing that has gotten worse since my last visit. Somehow there seems to be more cars and trucks on the roads. Just to give you an idea how difficult it is to move around Port au Prince, the distance between  Petionville and Carrefour, two suburbs of Port au Prince is about 20 kms, but it took us 90 minutes to drive, just crazy.

During our journey I had plenty of time to just people watch. It is amazing how many people are on the streets of Port au Prince, buying, selling or moving merchandise. My translator Leeox estimates that about 70 per cent of the population of Port au Prince (a city of approximately 1.2 million) make their living selling merchandise on the streets, with the average person making around $7 - $10 US dollars per day. But he says its much better than working in a hot stinky factory for only $5 US dollars a day. It certainly makes for a beehive of activity on the streets from sun up to sun down.

As we were navigating our way through the throng of street peddlers I noticed one gentleman missing the lower part of his right leg and leaning on a pair of crutches on a street corner. Then it dawned on me, he is the only person with a disability I have seen on the streets of Port au Prince. It is estimated that Haiti has over one million people living with a disability and a great many of those much live in Port au Prince, where are they. I asked Leeox why and he said there are a couple reasons; the city is generally lacking in sidewalks and the streets are too unsafe and where there are sidewalks that are accessible they are either littered with rubble, cluttered with parked cars or packed with street vendors. Leeox said most people with a disability go to school if they can afford it, or simply stay at home to help their family anyway they can. He also added that not a lot of people with disabilities are employed in Port au Prince. There is still a lot of public education that needs to occur in Haiti regarding the rights of disabled people.

Our first stop took us to see Sebastian, a nine year old boy who lost his mother and his right leg just above the knee when a wall fell on them during the quake. When I last met Sebastian he had just received his prothesis and was living with is aunt, uncle and cousins in a tent camp on a former city dump in Carrefour.

Unfortunately, not much has changed for Sebastian. He and his new family are still living in the same over-crowded, stuffy tent that is unbearable to sit in during the day. His aunt and uncle are still unemployed, despite several efforts to find work, meaning they can't afford school fees for Sebastian and two of his cousins and Sebastian is struggling to use his prosthesis because he says it's heavy and hard to manipulate on the rough terrain in the camp. It broke my heart to see his aunt and uncle struggling to explain how hard it is to provide for a family of six when no one is working.

But despite their circumstances, as I looked down at Sebastian I saw these huge, bright, brown eyes staring back at me and a mouthfull of shiny white teeth. His aunt and uncle say Sebastian is a very happy boy, and is constantly laughing and playing football, marbles or catch with many of the other children in the camp. The resilience of youth is unbelievable.

Next, we met up with ten year old Washline, or should I say she met up with us. As we were walking down a side street looking for her house she came bounding round the corner dancing and singing. This completely caught me off guard. In fact, I didn't believe this was our little Washline, who, as a result of the quake, had her left hip and femur broken in numerous places. Her father said the hospital staff told her she might never walk again, or worse, she might lose the leg. But thanks to some miraculous medical attention and the efforst of CBM physiotherapists, Washline not only can walk again, she can dance, sing, and run and play with her girlfriends.

This time its her father who is grinning from ear to ear. The family as a whole are doing much better. The father used to have a home and business before the quake but they were destroyed. They, like Sebastian's family, were living in a tent camp with no hope for the future. But the father managed to borrow a little money, has set up a small convenience store, which also serves as a house, and he can support his family and afford to pay for his three children to go to school. They still have a long way to go, but he feels they are on the road to recovery, and he says it was Washline's recovery that sparked the families recovery. As we say our goodbyes he shakes my hand and says he is forever grateful for how CBM gave his daughter and his family their lives back.

What a great way to end the day.

Yes there is still a lot of work that has to be done throughout Port au Prince, but people's lives are getting back on track one family at a time.

Thanks

From Brian Hatchell

I arrived safe and sound this morning in Port au Prince. Walking off the plane at the airport I was quickly reminded of how hot and humid Haiti is. As soon as the flight attendant opened the door a wall of thick, moist air rushed into the cabin and I began sweating before my feet even hit the stairs.

 

Driving from the airport to our guesthouse my head was on a swivel as I was trying to take everything in.

While I was expecting the worst, I must admit I was surprised at how much it looks like things have improved. There are still plenty of piles of rubble throughout the city, but I also saw a great number of homes/businesses that were completely cleared of rubble and were actually in the midst of reconstruction. There is definitely an indication that people are moving on and things are improving. The sidewalks were also packed with people selling their wares and plenty of takers. I could almost feel my shoulders drop as we drove along.

 

When I got to the guesthouse I unpacked, chatted with Joelle and Pierrot, the owners of our guesthouse and decided to crash early as I hadn't slept much since Thursday night. However, I was woken up to the sounds of thunderous rains. While I usually love the sound of rain against a window while sleeping, all I could think about were those living in tents and make-shift shelters, and wondering how they were doing. I kept praying for the rain to stop.

From Brian Hatchell

Just finishing packing in preparation of my return trip to Haiti tomorrow. Hard to believe it has been almost six months since I was last there. Not sure what to expect. I have seen and read plenty of news articles over the last few weeks, and from the sounds of it, not much has changed in the last few months. Rubble still dominates the landscape, people are still living in tents or make-shift shelters and the economy is still struggling to recovery. If that is indeed the case, it will be hard to see, because I know so many people are working hard to try and improve the situation, but the disaster was devastating and it will take years to fully recovery.

 

The one thing I am looking forward too is seeing the faces of the many survivors/beneficiaries I met during my last trip. Little Stefan and Fara, the three year old boy who was at risk of losing his right leg because of an infection and his ten year old sister who has spent months caring for him at the hospital. Sebastian, the nine year old boy wonder who lost his right leg, but whose strength of character has helped him become a neighbourhood celebrity. Saraudju, the ten year old girl with an intellectual disability that was attending one of our Child Day Care Centers, despite losing her home and her school she had such a quiet peace about her. And Magolie, the 28 year old woman who lost part of her right foot, but even worse, lost her four year old nephew when died on her chest, hours after the two of them were pinned under a collapsed wall.   

 

I am eager to see them all again, and see how they are doing. I must admit I'm a little anxious. I pray they are doing well and their lives have improved, but I worry that perhaps they haven't and I won't know what to say. I guess only time will tell.

From Brian Hatchell

Headed home today.

Hard to believe my time in Pakistan is over.

As I sit here in the airport waiting to board a plane for my journey back home, all I can think about are the people who lost theirs.

I've met so many people on this trip, young, old, male, female, rich, poor and they all have one thing in common - they lost everything to the floods.

Mother nature doesn't discriminate.

But neither does the spirit of survival.

Everyone I met, from the four year old boy who lost his father, to the 50 year man who lost his saw mill, to the widow who doesn't know where she will live after the waters recedes, all they want is a chance.

A chance to return home, a chance to rebuild their lives, a chance to regain their independence.

We are all greatful for assistance when we need it, but the basic human instinct is to make ones own way in this world.

The residents of Pakistan are no different.

Their will to survive and start over is strong.

They have faced many hardships over the last 10 years; the impact of the post 9-11 war in Afghanistan, the devastation of the 2005 earthquake, and now the floods.

These people have every reason to throw their hands up in the air and walk away.

But instead they dig deep, find the inner strength and continue to move forward one day at a time.

When I arrived here and saw the magnitude of the floods I honestly thought 'how will Pakistan ever recover from this.'

But the more people I met, the more stories of hope and courage I heard.

Pakistan will recover, the same way it always does, one day at a time, one family at a time.

Pakistan has a proud history, and although it will take time, probably years, this moment in time will become another chapter in that proud history.

The country, and its peope will recover, rebuild, and be better for it.

I just know it.

From Brian Hatchell

Went further into southern Punjab Province today to see and hear stories about flood survivors.

On the way we drove along a road that had been washed out by the floods. Water was still flowing over it about 4 inches deep.

All around all you could see was water and I was told this used to be some of the best crop lands in all of Pakistan. You would never have guessed it. It looked like the water had always been there. I was stunned to here the river that burst its banks and flooded this area was almost 100 kms away, and all the land between here and the river was submerged. That's hard to comprehend, the water had travelled 100 kms.

In its wake the water sparred no one, rich or poor. I met one family who said they were very poor and rented some land on which to farm. They had worked hard for years to build up cotton crops and acquired 17 cows. Unfortunately the family lost everything and has no money to rebuild. They say if they can't work the land they won't be able to pay rent and will probably be kicked off with nowhere to go.

Then I met one of the few families in Punjab who actually owned their own land and had a saw mill where they processed wood to make furniture. The head of the household told me they had a good life, plenty of food, a nice home and no worries. But they too lost everything including their crops and mill equipment.

Just like the other family they have no clue how they will rebuild and say it could be decades before they get back on their feet.

Natural disasters don't differentiate between rich or poor, they devastate everyone.

Some officials have told me the economy has been so badly effected they worry even micro-enterprise projects won't be able to help as no one has any money to purchase goods.

So they may have to go back to the barter system while people try to get back on their feet and then reintroduce money at a later date.

Can you imagine?  

From Brian Hatchell

Spent the day in southern Punjab Province, one of the hardest hit areas in Pakistan. We visited an tent camp for displaced people just outside Multan. As we were driving from Multan into the rural farming communities you could see the devastation all around you. Although the flooding occurred two weeks ago, and the water has receded quite a bit, most the prime crop land in this part of the country remains submerged.
 
Despite the presence of water we passed many families returning to their homes. Buses, trucks, motorcycles and even ox carts loaded down with everything the families could pack before fleeing. It didn't seem to matter what type of vehicle it was, they are seem loaded to within an inch of bursting.
 
Unfortunately, when most of the families arrive home there won't be much they can do except set up camp on the side of the road or any high ground they can find. Even so, most people at least want to return, now that the water is receding, to see what is left of their homes and crop lands. It will probably be another three to four weeks before all the water is gone, so that means another month sleeping under the stars in tents.
 
But it's only the lucky ones who have tents. Our journey touch us past many people lining the highway who didn't even have tents. Some simply hung a sheet or scarf on some sticks for cover. While those even less fortunate could only lean a bed or a piece of wood or tin on an angle like a lean-too to keep the sun and rain off them. It's hard to imagine living under those conditions.
 
When we finally got to the camp I was introduced to a woman named Nazir Bibi. She is a 50 year old mother of eight. When the water came she and her husband tried to pack up as much as they could and take their children to higher ground. Unfortunately, while wading through chest deep water her husband was swept away by the floods and drowned right in front of his children. Nazir struggled to recall the recent experience. Her four year old son Kaif has hardly spoken since the incident and her 12 year old daughter Samra can't stop crying.
 
Nazir doesn't know what the future holds. She would like to return to her house when the waters recede, but she knows it will be damaged and has no idea how she will pay to repair or rebuild it. She worries her two eldest sons will now have to find work to support the family.
 
I wanted to hug little Haif and tell him everything would be OK, but I couldn't. I can't guarantee everything will be OK. He young life has seen so much suffering already, and it isn't going to get any easier, at least not for awhile. I showed him a picture of my two young sons and he gave me a little smile. The only time I saw him express any emotion at all. i know he will be in my prayers tonight, and for many nights to come. His is a face I won't soon forget.  

From Brian Hatchell

Yesterday was a busy day.
 
In the morning we loaded up a truck with food packages for 371 people living in a village north-east of Peshawar. Apparently the village was a very poor community devastated by the floods. The food packages - provided by CHEF, one of our local partners - consisted of flour, rice, pulses, oil, sugar, tea, soap and a few other items. It will feed a family of seven for seven-to-ten days. It never ceases to amaze me how little food a family can live on in desperate times. Makes me realize once again how lucky we are in the 'western' world.
 
In the afternoon we visited a mother/child health clinic run by the Diocese of Peshawar, another one of our local partners. The clinic was very basic, but the health care being provided was truly life saving. The doctors say they see about 30 to 40 patients a day and most of them have skin disease, tuberculosis, diarrhoea, gastro-intestinal illnesses and even some cases of cholera and malnutrition. The staff working in the clinic were truly dedicated, many of them lost their homes in the flood, but they continue to come to work and help those less fortunate.
 
I met one woman who is 35 years old, married with six children between the ages of six and twenty. She is also blind in one eye. When the floods came around 2 am in the morning she says she woke up to the sounds of screaming. When she and her husband jumped out of bed there was already water on the floor of their house. Her husband ran to grab the younger children, while the older ones came to help her because she can't see well and it was completely dark. They ran to higher ground to escape the flooding. The next day they went to a Diocese relief camp. They Diocese provided them with shelter, food, water and medical care for almost a month. But the family wanted desperately to return home. So on August 25 they went back home, to find their house heavily damaged. The foundation had shifted, all the walls had cracks, and all their belongings were either washed away or damaged beyond repair. However, they decided to stay there, 'it is our home' Laviza says, 'where else could we go?' The couple say they don't have the money to rent a house or to repair the damages. Despite all of this, Laviza and her family say they are blessed by God. No one was hurt, and the Diocese was there, and still is there helping. The Diocese has provided the family with some basic clothing, household items and cooking supplies. The Diocese hopes to be able to help the family repair their house, or rebuild it if need be, but they need to raise the funds to do so.
 
In this small community of about 120 families, almost everyone lost everything and the Diocese hopes to help them all by either repairing or rebuilding their homes. But it will take time, probably the better part of a year. Bishop Humphrey Sarfaraz Peters says the Diocese hopes to repair or rebuild about 750 homes in northern Pakistan before next monsoon season. As he says that he laughs a little, 'let's hope next monsoon is a little more forgiving.' he says. 

From Brian Hatchell

Since returning to northern Pakistan from my trip to the south I have unfortunately been chained to my desk unable to attend any relief operations because of security concerns. Security is a major issue in northern Pakistan. As if people in this part of the country devastated by floods needed something else to worry about. I hope to be able to attend some relief initiatives over the coming days to get a better idea of the impact the efforts of our local partners are having to those returning home.

The rains and have stopped and the flood waters in the north have receded, meaning millions of people can return home, or at least to what was once their home. Many of the homes in this part of the country were built with bricks and mud, when the flood waters came they were simply swept away. It will takes months if not years to rebuild the tens of thousands of homes, school and businesses either damaged or destroyed.

The other issue will be reclaiming fertile crop lands. When the rushing waters came barrelling through this part of the country they brought with them soccer ball sized rocks from the base of the Himalayas. I have seen prime crop land completely covered in these rocks, you would never have even know it was a field unless someone told you. Cleaning away all those rocks will take weeks if not months before any crop can be planted. If the farmers can get a new crop into the ground before the end of September, they have a chance to harvest it before the end of the year and earn some much needed income to get back on their feet. CBM and our partners are providing these people with tools and equipment to clean up their homes and crop lands, and will continue to provide food, water and medical services for the next six month while they get back on their feet.

However, most children will be needed to help rebuild their homes, reclaim their farmland and plant/harvest the new crops, meaning the chances of them returning to school any time soon is slim. Just another indication of the long-term impact of these floods.

From Brian Hatchell

Spent the day today in Thatta, a village 120 kms west of Karachi in Sindh Province, southern Pakistan, the latest area to be hit hard by flood waters.

As we were driving from Karachi to Thatta you could thousands of people fleeing, headed for Karachi, a city of 18 million, hoping they will find help. Many people were just walking along the side of the road with whatever they could carry. Some packed whatever they could along with as many as 15 family members into a pick-up to make the journey. Many more simply decided it was too far a journey and simply set up camp on the side of the highway.

It looks like something out a movie, something you only see on TV, not in real life. Thatta is a town of 800,000 right on the Indus River, already more than 200,000 have been forced to flee and that number is expected to increase and the flood waters continue to rise as the Indus flow into the Arabian Sea.

As we got closer to Thatta all I could see was water. At first I didn't think anything of it because I thought it was the Indus River, but I was told the river is still a fair distance away, these were crop fields. It was unbelievable. wherever you looked was water, and people on the move.

We distributed food packs to about 315 families of persons living with a disability in a makeshift camp. The packs would feed a family of five for seven days. It doesn't seen like much in the face of hundreds of thousands, but it matters a lot to those families.

Perhaps the most impactful part of our journey however occured on the way back to Karachi. We saw one family sitting on the side of the road with nothing but a sheet to sheild them from the sun. When we turned around we discovered they were a family of 15 that had fled Thatta two days ago. They had rented an ox cart and fled with nothing but the clothes on their backs. They needed the cart because two of their daughters had Muscular Dystrophy and one of them is a wheelchair user.

Unfortunately half way to Karachin the driver said he wouldn't go any further and kicked them out of the cart. When we found them, they had been there two days, without any food or water or proper shelter. We had nothing to give them as we had already distributed our food, but we could offer them a lift. So we packed them into the back of our truck and drove them the final 60 kms into Karachi. We took them to a government run camp for displaced people. At least now they will be registered in a camp, given a tent, some food and water and the daughters will receive medical attention.

It is easy to be overwhelmed by the size of a disaster affecting more than 20 million people. But when you look at it as one family at a time, it seems more managable, and you feel like you are actually making a difference in the lives of survivors.

Off to Peshawar in the north where the flood waters have receded and people are starting to make their way back home, or back to what is left of their homes.