Pakistan’s challenges have now entered into a new phase with the commencement of peace negotiation with militants while violent attacks from both ends continue and the common people’s challenges for decent living remain stiff as before, in fact increased. The case of Tharparkar gave one more evidence of government’s insensible attitude towards people’s problems.
Surveys conducted are highlighting the facts that drought in Tharparker is mismanaged and misperceived by the authorities, the food was there but people could not access it, people’s power of purchase diminished due to their animals’ death, they were not able to carry their children to hospitals or health facilities because they did not have money or any transport services. Nevertheless, struggle for the betterment should not be stopped and following this principle HANDS is achieving its results in such challenging environment and laying examples of persistent efforts.
In present newsletter readers can find HANDS quarterly organizational report’s highlights which are presenting spectacular acceleration of HANDS’ beneficiaries in terms of capacity building trainings, income generation support, health and education services to underprivileged people and especially roof over their heads. The readers must find Tharparker realities interesting, included in this issue of newsletter. Moreover, concentration has been given to provide information to readers about issues for which HANDS is providing its services to deprived communities.
This is very encouraging that HANDS is now at the position where public and private sector stakeholders both approach HANDS when it comes to disaster mitigation or any other strategic interventions initiated in the country. This is more important that confidence of communities on HANDS is more stronger and they are doing their own efforts on self reliant basis and leading and taking ownerships of projects like incase of Adolescent Friendly Centers have now been taken up by the community youth on self sustained basis. MARVIs are becoming more and more self sustained by selling daily utility products in conjunction to the services of Family Planning, men and women are more strengthened to earn their own livings by learning through marketing and social enterprise development trainings.
I hope this issue of the newsletter gives readers a holistic sense of efforts and results which are coming through HANDS visionary leadership only.
HANDS’ beneficiaries reach to 1 million
According to HANDS’ recent quarterly report, the numerous projects and programmatic sectors of HANDS have reached 0.90 million people as direct beneficiaries in the 2nd quarter of 2013-2014, as per the set targets. HANDS’ intervention facilitates the beneficiaries to solve their problems at community level, thus maintaining community participation as the most important priority.
HANDS Human Institutional Development Program conducted 62 trainings for 1990 participants to strengthen the skills of individuals and groups. Through its Social Mobilization approach, HANDS has been able to facilitate local community and formulated 450 men and women Community based Organizations (CBOs) in the mentioned quarter.
The past quarter remained significant for the Disaster Management program due to Earthquake hit areas of Tehsil Awaran and Mashkay where HANDS distributed food to 210 affected families, provided medicines to 558 families and treated 5594 patients through mobile medical camps. HANDS also provided 5,555 non-food items to the victims. Simultaneously, the series of projects running under Infrastructure Development, Energy, WASH and Shelter (IDEAS) have 327,382 direct beneficiaries.
HANDS believes in the financial empowerment of community through providing cash for work, Hunarmand Training Centre sessions and livelihood assets. This Livelihood Enhancements program has directly empowered 14,015 people. Moreover, an estimated 312,757 beneficiaries have been reached by Health Promotion Program in 28 districts through 2878 intervention units.
Further intervention reveals about HANDS’ community teachers for ECE, Parwarish centres, adult literacy centres and government teachers of primary and secondary schools to benefit about 24,118 number of community members.
All of the HANDS projects are based on the best practice models developed by Monitoring, Evaluation and Research program (MER) which conducted 04 researches on school facility assessment in Awaran, DFID Endline Evaluation, pilot study on beneficiaries’ feedback collection and WASH profile and surveyed 4031 intervention units.
Tharparkar Drought Realities
The ‘1st Situation Analysis Survey – Tharparkar’
by HANDS in support from UN-OCHA
HANDS has been able to release the rapid assessment report on Tharparkar famine disaster in technical support with UN-OCHA, to understand the situation of the people and to identify the root causes and result in action plan by the government and donor bodies. This document provides findings of a rapid assessment based on interviews with key informants (KIs) conducted by HANDS, from 11-14 March 2014, across 322 villages in Tharparkar districts. A standard tool of MIRA (Multi Cluster Initial Assessment) was used in this survey. The report reveals that 35 percent of the 15,077 families that depend on agriculture have been affected and require assistance to restore their livelihoods. Also 10,725 herds of livestock were reportedly lost. Some 55 percent of the communities reported that they have no fodder for their livestock, and another 42 percent reported available fodder sufficient for two to four weeks. A further 88 percent of the 6,433 families that depend on daily labour as their primary source of income have lost their livelihood, this created cash deprivation which hindered their communication and travelling to reach food and health facilities. Hence, immediate assistance in this regard was important.
The main health problems reported by key informants in the drought hit areas are diarrhea at 87percent, fever and malaria at 82
percent, followed by cough and respiratory tract infections at 79 percent, and lastly by skin diseases at 41 percent. It can be assumed that given their heightened vulnerability, they will require specific attention and specialized care by the trained healthcare providers. During the assessment, 66 percent respondents reported that nearest health facility is at a distance of more than 5 kilometers and of those 26 percent highlighted basic health unit (BHU) as nearest health facility, 24 percent reported DHQ/THQ as nearest health facility and 19 percent report dispensary as nearest health facility for them while in 32 percent village’s nearest facility was reported not functional which indicate more than one third population has to travel a long distance for availing healthcare services.
During the assessment, key informants of 39 percent villages reported that there are reports of women who have stopped or reduced breastfeeding after the drought, there is also a decrease in exclusive breastfeeding after drought which is 11 percent less than before (39 percent), an indicator strongly associated with an increased risk of malnutrition in infants and young children. In addition to that, infants and young children are also given goat milk, wheat flour, rice and biscuits as supplementary food. Water related issues were not of concern during calamity. As reported by 322 village’s key informants, water was accessible in most of the villages but more than 99 percent of the households do not treat drinking water as they count well water as safe. Women are widely engaged to fetch water from nearby sources, and nearly three quarter women spend one hour to collect the water. Only 11percent of the KIs identified problems in obtaining assistance in drought situation while 15percent of KIs reported security concern in the community. Radio and mobile phones are the main source of communication in visiting villages. Some 63percent informants reported mobile phone as primary source of communication, 53 percent KIs reported radio as mode of primary source of communication and 13 percent reported NGO staff is also primary of source of communication.
The report sends recommendations for short term relief till monsoon and long term 10 years’ strategy. This includes cash
compensation and supplies of livestock, seed distribution, restoration of irrigation, availability of safe drinking water, dry ration supply at door-step, provision of primary, secondary and tertiary health facilities, free or subsidized transport system and activation of awareness campaign with of mobile phones and FM radio.
According to Rahim Marri, GM, Disaster Management, HANDS, “Fortunately, the recent formation of HANDS’ nutrition management teams, helped in implementing an immediate vertical action plan in response to the famine emergency killing over hundred children. Our facility based nutritional management approach, static and mobile teams will be providing adequate nutritional care and treatment to malnourished children less than 05 years of age, pregnant and lactating women with acute malnutrition. Also, micronutrient deficiencies would be overcome through provision of micronutrients, vitamin and de-worming.
HANDS volunteers engrossed in assisting the disaster victims at Mithi District Hospital.
A group of 11 healthcare providers under the leadership of Dean Khyber Medical University, KPK, along with CE HANDS, visited HANDS intervention area in Taluka Deplo and organized Mobile medical camps at various locations. About 850 patients were initially treated and provided medicines with support of HANDS medical camps.
HANDS promotes women autonomy
A challenge to the much celebrated notion of women empowerment still remains in the provision of basic ownership rights, a sheltered roof, health and education. In Pakistan, the notion of women empowerment can become a thronging reality only when the great challenge gathered up against the status quo for women’s equality and vigilance is channelized. The status quo in Pakistan sets rigid limits on women’s ownership of productive resources and rights to inherit property.In terms of integrated development, HANDS has effectively mapped rural Pakistan, mostly Sindh, providing women autonomy over land ownership through its Shelter program, supported by Department for International Development (UKAID), Medico International (MI) and several indigenous philanthropists. In this regards HANDS is striving since long for empowering women but in relief intervention this opportunity get doubled through which more than 0.1 million shelters were been handed over to flood victims in Sindh, Punjab and Balochistan in which female headed households have been given major priority in shelter provision. A large number of women now owned their own houses.The development model particularly addresses livelihood enhancement of people in which women are given more priority. The target areas of rural Pakistan are generally bound by land values, inheritance traditions, ethnic backgrounds; and a mix of micro, small, and large landholdings. Through intervention, HANDS has been able to overcome the bureaucratic roadblocks and medieval record keeping which makes the documentations inaccessible to women in these areas. The authentic and transparent provision of land documentation, social protection documents, building of resilient shelters along with the provision of livelihood opportunities has raised these women to support their families in a protected environment.Imamzaadi, Karimaan, and Haseena are among many women who are leading a self-reliant life. The roof over their heads has enabled them to raise their families with respect and dignity. They are no more required to engage in vocations unsuited to females. HANDS has also formed 2482 and women CBOs out of a total 5205 in almost 20 districts of Sindh, Punjab and Balochistan.The best practice models deployed by HANDS include service, training and delivery, where after a diligent need assessment, women have been made socially aware to utilize the material resources and initiate their livelihoods on a continuous basis.
Women seen with their owned house property
Commitment to Adolescent Reproductive Health
From left: Dr. Irfan Ahmed, Dr. Zahoor Ahmed, Dr. Khalid Parvez and Aijaz Memon delivering key aspects of reproductive health for adolescents.
HANDS Thatta organized an ‘Advocacy & Experience sharing Workshop’ on Adolescents Sexual & Reproductive Health & Rights (ASHR), organized at Government Polytechnic Institute auditorium, Thatta, on January 29, 2014. The workshop was held under Reproductive Health Initiative with Adolescent (RHIA) project, Basic Skills for Life (BS4L) component.
Dr. Irfan Ahmed, Senior Country Health Advisor, Plan-Pakistan, Dr. Zahoor Ahmed, DHO Thatta, Dr. Khalid Pervez, Ex-GM Health, HANDS Head Office Karachi, Line Department officials, community members from RHIA villages, learners of respective AFCs, AFC staff, HANDS team, NGOs representatives and youth groups were among the guests.
Community members shared their experiences of HANDS intervention and expressed satisfaction on confidence building, personality development and health improvements after the provision of reproductive health education by HANDS.
Guest speakers were pleased to see youth actively questioning about their issues. They said that this is a change in confidence building, no matter little bit. At community level, as well as generally we have to build responsible attitudes towards leading life.
The guests on the occasion also acknowledged the feedback from community and appreciated the ASRH model.
Access, Services and Knowledge
ASK’s reproductive health efforts
HANDS is the implementing partner for Rutgers WPF’s ASK (Access, Services and Knolwedge) project. Regarding Sexual Reproductive Health, the program aims to build young people’s individual capacity to make safe choices; to make SRH services better adapted to young people’s individual needs; and to strengthen the linkages between information and service provision.
ASK aims to target young people between the ages 10-24 years, especially adolescent girls and marginalized youth groups like sexual, ethnic or religious minorities, people with disabilities, sex workers, and young people living with HIV (YPLHIV). The program is focused in Karachi, Quetta, Lahore, Islamabad, Multan, Matiari. In this regard, a website http://www.youask.pk/ has been developed to support youth.
RHIA Field Visit
Dr. Irfan Ahmed, Senior Country Health Advisor, Plan-Pakistan, visited Adolescent Friendly Centre boys’ and girls’ Fateh
Muhammad Soomro, and MARVI house, facilitated by HANDS Thatta, on January 29, 2014.
24 Adolescent Friendly Centres handed over to community
The community of Thatta and Kot Addu are benefiting from the 24 Adolescent Friendly Centres established by HANDS, separately for boys and girls with financial support from Plan-Pakistan. These centres are aimed to overcome the sexual reproductive health problems among youth. Even in normal settings, adolescents face social and structural barriers that prevent them from accessing ASRH services.
Adolescent Friendly Centres provide recreational, educational and social awareness opportunities to the youth. Psychosocial problems, habits of drugs and irrelevant company and negative behavior are dealt with through counseling and healthy activities. The centres are equipped with space for sports, computers and gathering areas.
In general settings, there are high health issues and risks faced by children and adolescents. AFC plays the role for generating income resources for the sake of children and family, provides them better health and education, protects them from diseases and keeps them away from bad practices causing health deficiency.
Some facts about ASRH
- The adolescent group, aged 10 to 19 years, are mostly at high risk in developing countries in situations of: pregnant adolescent girls, marginalized adolescents i.e. HIV+, those with disabilities, LGBT (homosexual issues), indigenous groups, migrants and child laborers.
- Adolescents make up about 22% of the population in Pakistan.
- In Pakistan 50% of women give birth before the age of 20.
- Young women are at increased risk of morbidity and mortality during pregnancy and childbirth.
- 1/2 of new HIV infections occur in 15-24 year olds.
- 1/3 of new cases of sexually transmitted infections (STIs) occur in people under 25 years.
Annual Status of Education Report
According to the Annual Status of Education Report – ASER 2013 National survey, despite the recent focus of the federal and provincial governments on enrolment drives as a rhetoric on Article 25A, 21 percent of Pakistan’s children between the ages of 5 and 16 still remain out of school. The remaining 79% that are enrolled in the 5-16 age bracket are not learning much either. These findings were made public in the report of Pakistan’s largest-annual citizen-led household based ASER Survey 2013. The ASER sample included 249,832 children (including 41 percent girls) by 10,000 volunteer citizens, who personally visited 81,672 households in 4,112 villages as well as 14,158 children (including 42 per cent girls) 5,372 households in 270 blocks in urban areas of 13 districts across Pakistan.
For the year 2013, the ASER rural survey has been conducted in 138 rural districts in the country, wherein 5-16 year age cohort children were tested for English language, Urdu, Sindhi, Pushto and arithmetic competencies. The report aims to inform the progress or lack thereof with respect to Article 25 A of the constitution making education a fundamental right for 5-16 year old children since 2010.
The report states that the private sector is performing better than the government sector as far as the learninglevels of children, student and teacher attendance are concerned. The survey reveals a clear- urban-rural divide, whereby urban areas perform better in terms of access (92% children in schools vs. 78% in rural areas) and infrastructure facilities; however, learning levels remain marginally better than rural areas with a high incidence of private tuition in urban areas.
From Right: Mr. Taj Haider, Mr. Arif Alvi, , Mr. Zakir Shah, Mr. Mohamamd Hussain Mehanti, Dr. Suleman Shaikh, Dr. Shaikh Tanveer Ahmed, Ms. Sabiha Mushtaq, Mr. Asghar Soomro and Mr. Naveed Shaikh during the launch of Aser Report 2013.
Teachers Training on Psychosocial Well-being
Two day teachers training, conducted by HANDS Institute of Community Development, on psychological well being joyful learning
environment held at HANDS institute of community development Awaran Balochistan on 22nd – 23rd January 2014.
HANDS extends psychosocial support for vulnerable groups of men, women and children to recover from trauma caused by disasters. HANDS believes it is essential to address the emotional and social needs of victims within a safe and protective environment.
The content delivered in the training generally involves definition of mental health, post traumatic stress disorder, schizophrenia, basic helping skills, psychosocial competencies, community consultation and social animation.
WaterAid Partners’ Forum
Partners’ Forum 2013-2014 was organized by WaterAid on March 04 and 05, 2014, at Islamabad. Dr. Shaikh Tanveer Ahmed and Ghulam Mustafa Zaor, provided their motivation by being a part of this national level forum and presented HANDS’ approach to the audience.
HANDS is implementing two Urban WASH projects in the Gadap town of Karachi in collaboration with Wate
r Aid. The project helps marginalized communities to establish sustainable water supplies, sanitation and hygienic behavior through benefiting 134,900 number of people in urban slums and 69,000 students.
It is anticipated that such forums will lead to develop sustainable social innovations related to Water, Sanitation and Hygiene, and networking of stakeholders at national level.
HANDS Board Members’ visit to Hala
Honorable HANDS Board Members visited Hala on the 16th of February, 2014. Mr. Ghulam Hussain Baloch, Ms. Siraj-un-Nisa Essani, Dr. Saeed Ismail, Mr. Abdul Wahid Sangrasi, Dr. Mustaghis-ur-Rehman and Dr. Ghulam Farooq visited the sites of DRM Centre, MI Intervention Units, CMW School and Display Centre were visited at HANDS Hala to observe HANDS’ work at grass root level .
The team of HANDS Hala expressed their gratitude to Dr. Sheikh Tanveer on the visit. Ms. Abida Jawaid, Mr. Haji Ahmed, Mr. Munir Baloch, Mr. Abdullah Kerio, Ms. Shakeela Memon, Ms. Monam Naz, Mr. Alamgir Balal, Ms. Yasmeen Zehra, Mr. Sada and Ms. Sanober from HANDS Hala team were present on the occasion.
Initiation of new projects
HANDS has entered prominent agreements of community service projects during October-December, 2013:
- Access Services and Knowledge with Rutgers WPF
- General food distribution with Oxfam
- Relief and recovery for Awaran disaster with DFID
- Sindh community mobilization with USAID/IRD,
- Livelihood with PPAF
- Sehat project phase 3 with GAVI.
- Hand pumps installation with Abu Faisal Trust
In picture: Dr. Tanveer Shaikh, Chief Executive HANDS, along with Dr. Mohsina Bilgrami, Country Head, Marie Stopes Society, during Sub-Award Signing Ceremony of MSS project of family planning and reproductive health services in 10 districts of Sindh.
Packard visits MARVI
Dr. Iftikhar Ahmed from Packard Foundation along with HANDS officials visited 03 Marvi workers at District Umerkot, on January 30 and 31, 2014. The delegation met all Marvi staff and gave encouraging remarks on Marvi performance in providing healthcare to women of the area.
Medico International’s support continues
In continuation of 2011 flood response, MI also supporting through TAMEER III project in District Matiari, building 05 model villages with integrated development approach by constructing 553 shelters, streets, culverts, seed storage, installation of hand pumps establishing ECE classes, MARVI health houses, providing livelihood assets, establishing market price information center, display center for handicrafts, community nurseries, model agriculture farms, hatcheries, flour mills and capacity building trainings for community members. MI also funding to provide solar lights to 1125 families of Matiari. MI is also supporting HANDS to establish provincial level disaster risk management centre to be constructed at HANDS ICD Gadap near Baqai medical university.
A 7.8 magnitude earthquake struck Balochistan on September 24, 2013. The quake’s epicentre being in the Awaran District also affected other districts of Kech (Turbat), Panjgore, Chaghai, Khuzdar and Gwadar. These areas were hit again at 7.2 magnitude on September 28, 2013.
- According to Provincial Authority, around 300,000 population was affected with over 359 deaths and 619 injured in districts Awaran, Ketch and Panjgore.
- Around 90% of the buildings were collapsed including shops, houses and schools in these districts.
HANDS has reached a population of 56,000 individuals (10,000 households) in earth quake affected districts of Balochistan. Project covers communities of 08 affected union councils (Awaran, Gajar, Nokjo Teertaje, Parwar, Gishkore, Chitkan (Panjgore), Dadar (Ketch) of 03 districts of Balochistan. The emergency relief package comprises of emergency shelter kit, non food items (consisting of solar light, ceramic filters), emergency healthcare, antenatal, postnatal care, physiotherapy of injured patients, rehabilitation of disabled, establishment of child friendly spaces and cash for work activities. Roofing kits and winterization kits have also been provided for 10,000 families.
My official visit to District Awaran, first ever at all, started on the 10th of February, 2014. To capture Awaran’s post earthquake distress and HANDS’ intervention in the form of documentary, we set off at 9 in the morning, accompanied by five other HANDS staff members.
We paused at Bela by Zuhr prayer time. The mountains of Awaran were visible as soon as we crossed Jahu. On our way to Awaran, up to the farthest sight there was barren land, mountains and carved roads. By the last of the daylight hours we had reached the first FC check post to seek permission into the city after basic inquiry about us and our visit purpose. Amid high barren mountains, the first sight of Awaran city was indeed beautiful. Our arrival at the rest house was followed by planning meeting for the next day.
HANDS had begun its relief activities from October 2013 with formal initiation of project a month later in November. In order to capture this intervention by HANDS, my camera lense had to play its role now.
In a double cabin vehicle, we were set to our first visit destination to Mangoli village at a 2 hour distance from Awaran. The way was mercilessly rough, in absence of roads and surrounded with unending mountain ranges and barren land. As an hour passed, there were Pakistan Army personnel visible on a hill. We were stopped and once again inquired, this time by Army officials, on a check post 10 minutes away from Mangoli.
Mangoli had nothing to show except distress with wreckage of houses here and there. Village people did not show any estrangement due to the local HANDS staff who was already engaged in material distribution there. In addition, I myself a Baloch, did not find any difficulty in bonding up with the
locals. Entire Awaran has 100 percent Balochi speaking people. We captured our planned footage and started off for another village at a distance, which showed similar crippled view. Meanwhile, the sun was setting for the day to make us return.
On the second day, Awaran city Union Council remained the starting point. We visited a temporary school built by HANDS. To our delight, the students were engrossed in their studies and the teachers gave much positive feedback about HANDS training which equipped them to deal with students on their psychosocial levels. Students could be seen content.
After filming the school, we went to capture another village. It took us almost two hours, not because of the distance but the track was uneven and difficult. HANDS medical staff was installing camps at the village. On meeting with the locals, there was an apparent agony on their faces and attitudes. The majority of patients were trauma victims. We got done with the filming. However our next destination village was scheduled with a community meeting but the village people were not available at that time. Due to worsening security conditions, we were suggested to leave the area at the earliest. But fate had its own move, we were immediately surrounded by veiled men as we left. They ordered us to step out of the car and asked for our identity cards. Each one of us was separately called by name. On my turn, I was questioned about my permanent residence and ethnicity, after which I was released. But it was not the same with one non-Baloch team member, as he was confronted on his purpose to enter the area. Though, we were finally released after their long argument with HANDS District Office Manager. Another of HANDS staff car coming on the same way soon after us faced the same scenario.
The next day de-briefing clearly revealed that security conditions in the area are hampering the relief activities. It was also noted that the senior management should release strict dos and don’ts for the field team so that they are able to achieve their goals. Though my car was once again running on the streets of Karachi after four to five hours, but Awaran visit was surely was an unforgettable journey for me. I have taken deep insights from the lives of people. I wish to revisit the area on project completion and witness the difference in people’s lives made by HANDS.
Sindh as a model province for taking up Child Marriage Issue
By Bilquis Rehman
The last quarter of Adolescent Girls’ Empowerment (AGE) project remained focused on pushing for the passing of Sindh child Marriage Eradication bill. Effective sensitization of stake holders, especially media and legislators, took place to build a movement for bill approval in the Assembly. In order to mobilize the civil society for pressure building, series of meetings have been conducted with Department of Women Development and media. The special focus has been given to alliance building with major NGOs working for child rights and sexual and reproductive health rights (SRHR). The enthusiasm and unity shown by all alliance NGOs have added to the optimism for child marriage advocacy and in implementation of the law. From Karachi to Jacobabad, journalists have been brought on a common ground, which has enabled that journalists are self initiating the advocacy against child marriages. This is evident in electronic and print media reporting on the criticism by Moulana Sherani, Chairman of Islamic Ideological Council, on child marriage bill. A number of channels and newspapers gave ample airtime and space to debate on the issue. This is also encouraging to have favourable stance of both, ruling parties and opposition parties of Sindh. They have given their assurance on all platforms to support this bill and stressed to pass it in Sindh Assembly.
The Sindh Child Marriage Eradication Bill that has been tabled in Sindh Assembly in December 2013 is on the way for its approval. The committee was appointed by Speaker Sindh Assembly to review the two bills presented by Minister Women Development and Ms. Sharmeela Farooqui and merge both into one. The said committee did number of meetings and forwarded its recommendations for finalizing the bill draft. Now the committee has conducted its final consensus meeting over all suggestions and remarks and has put forward the finalized version of consensus draft. It is expected that in upcoming Assembly session Sindh child Marriage Eradication bill will be presented to pass. Thus, Sindh has become a model province for successful inclusive campaign against child marriage issue and has brought law to curb this social peril.
Alliance against child marriages has evolved during the campaign for child marriage legislation. The core team of the Alliance consist of organization Rutgers WPF, HANDS, Action Aid, Shirkatgaah and Aurat Foundation. Members of Alliance met for exchanging considerations over enabling a far effective movement against the early marriage customs and for that Alliance discussed to involved more stake holder in the Alliance like Media, religious scholars, social and political figures to strengthen the movement.
Alliance meeting is regularly conducted for strong lobbying to impact child marriage legislation. Last Alliance meeting was held in first week of March to discuss position of the bill.