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Evaluation Oxfam evaluation of Cyclone Sidr response A boy stands next to his makeshift home in Patarghata (Barguna District). Kenny Rae/Oxfam America, Bangladesh, 2007 Late in the evening of 15th November both with each other and with government. In 2007, Cyclone Sidr struck Bangladesh’s part, this appears to be the result of the poor southern coastal areas leaving around sharing of information and a lack of established 4000 people dead and millions homeless. communication channels between donors The cyclone also killed livestock and destroyed crops, farming equipment, and fishing boats. Planning for the emergency was belonging to the Organisation for Economic Cooperation and Development’s Development Assistance Committee (OECD-DEC) and other already well underway before the cyclone hit countries who fall outside this group. land. Early warning systems and disaster preparedness measures allowed a reported 3 million people to evacuate low-lying coastal areas and local government officials and nongovernmental organisations (NGOs) rapidly to Government officials and Dhaka-based donors appear to have had little or no information on the timeframe within which substantial bilateral pledges were being spent or which activities they were funding. move contingency stocks from neighbouring Targeting the right people for relief was districts into the areas of anticipated impact. another major challenge in the emergency Following the cyclone’s landfall, the government, armed forces, local civil society organisa- benefit the most vulnerable, such as female and response. Relief distributions did not always tions and volunteers moved quickly to mount child-headed households or elderly and search and rescue operations and to distribute disabled people. In part this may have been the food, water, logging and other emergency items result of people’s needs outstripping available to survivors. The reduced death toll compared resources. However, due to the information gap to previous cyclones is a testament to improved between national policy-makers and field staff, community preparedness measures and a credit those leading the response did not pick up on to the 43,000 volunteers working under the additional needs early enough to allow donors government funded Cyclone Preparedness to respond with more assistance. In light of Programme. financial and material constraints, NGOs delivering While the immediate response to the disaster was both prompt and vigorous, Oxfam believes that some actors could and should have done more effectively to meet emergency needs. While coordination at local level was reasonably effective, gaps were visible in coordination between local and national actors, resulting in poor quality humanitarian response. Since field based staff and officials within national NGOs the assistance often found it difficult to select beneficiaries. This seems to have been a particular challenge for NGOs who had previously carried out development work in the same villages. A strong developmental approach meant that staff sometimes struggled to develop and explain to communities the new selection criteria required for an equitable emergency response. and institutions were rarely empowered to Considering the fact that the vast majority of make programmatic and policy decisions - for assistance programmes in Bangladesh are example, regarding numbers of households to implemented by local actors, international target or types of items to distribute - large parts donors and aid agencies have not invested of the response remained resource-driven and adequately in strengthening these frontline ‘top-down’, rather than needs based. responders in disaster-prone areas. More efforts Above all, coordination at both the national and local level appears to have been hampered by a lack of strategic focus. While the informal activation of the United Nations (UN) ‘cluster approach’ to humanitarian coordination did are needed to build these organisations’ capacity, especially in terms of beneficiary selection, the application of international quality standards such as Sphere standards and effective contingency planning. allow those involved in the response to meet In terms of recovery there are still two more regularly at Dhaka level, the clusters massive gaps – the repair and reconstruction of themselves were not utilised by either the homes and the rehabilitation of people’s livelihoods. government or UN agencies as a space for genuine policy discussions around actual needs on the ground. With regard to the UN system, Nearly 1.5 million homes were destroyed or the absence of a clearly identifiable, inclusive damaged due to the cyclone and subsequent inter-agency coordination forum, as well as a storm surge. Damage assessments estimates are dedicated Humanitarian Coordinator (HC) or 800 million dollars. To its credit, the government other high-level UN official, also resulted in of Bangladesh acted immediately after the disaster to provide families whose homes were fully missed opportunities in terms of joint planning and preparedness. destroyed in the worst affected areas with a oneoff housing grant. Carried out with remarkable Cross-cutting issues like gender and protection appear to have fallen through the cracks as be an innovative way of supporting extremely speed and efficiency, this distribution proved to clusters were limited to discussing the more vulnerable families. It was clear, however, that technical and practical aspects of the response. Many multilateral and bilateral donors gave 1 Oxfam Briefing Note (2008). After the cyclone: lessons Summary of evaluation 1 generously during the first phase of the response but struggled to coordinate assistance from a disaster. 15th February 2008. Full report at http://www.oxfam.org/en/policy/bp_bangladesh_cyclone_sid r_080214 the amount was insufficient to allow families to actually rebuild their homes. Most people interviewed by Oxfam reported having spent their cash on other emergency needs, such as foods or winter clothing for children, as well as to support recovery of livelihoods. The cyclone killed over 1.2 million livestock and destroyed nearly 2.5 million acres of crops. Damage and losses were estimated at 500 million dollars, with large numbers of communities that were previously reliant on agriculture, fishing and casual labour having lost both their incomes and assets. Food security needs were significant. The World Food Programme (WFP) led the food security cluster in calling for relief distributions to continue for more than 2.2 million people until at least May 2008. However, Oxfam feel that the clusters, by not advocating for more seed distribution, missed an opportunity for improving some people’s food security. Also, the fact that 95% of local markets functioned again suggested that some cash-based responses may have been appropriate. Loans and credit are a major source of income for many rural families in Bangladesh. Most families were already carrying debt loads before the cyclone. Following the cyclone, some microfinance institutions took decisions to temporarily suspend repayment of loans but communities expressed fears that current grace periods of 3-6 months were not long enough. These institutions must follow government advice and be more flexible, as well as write-off loans in cyclone affected areas as much as possible. There has also been unscrupulous lending at very high interest rates for new loans. Special efforts will be needed to ensure that sufficient amounts of credit are offered by micro-finance institutions and banks at low or no interest rates to facilitate recovery of those affected by the cyclone. Considering the country’s high level of vulnerability to natural disasters, the government and international donors must commit to better rebuilding and so improve future resilience to disasters. Scientists concur that the ferocity and frequency of hazard events such as cyclones, hurricanes, and earthquakes have increased. Few countries are at higher risk of climate change than Bangladesh where experts estimate that more than 50 million people could be made homeless by rising temperatures and sea levels. Climate migrants already account for at least one third of the impoverished people who are flooding from rural areas to seek work in the city of Dhaka. Cyclone survivors have demonstrated a remarkable resilience in the face of disaster but their capacity to cope with the enormous challenge of rebuilding their lives must not be overestimated. The government of Bangladesh and the international community have a legal and moral responsibility for ensuring that their needs do not fall off a crowded humanitarian and development agenda. Nutriset, Niamey, Mali, 2007 Utteran (Oxfam partner) Cash for Work programme for communities to build latrines to replace those damaged by Cyclone Sidr. 29
Field Article Nutriset, Niamey, Mali, 2007 New method for assessing acute malnutrition in nomadic pastoralist populations By Anne-Marie Mayer, Mark Myatt, Myriam Ait Aissa and Nuria Salse Anne-Marie Mayer is a technical consultant for this project and carried out the first field test in Mali with ACH. She has a PhD in International Nutrition from Cornell University and has worked in Ethiopia with Save the Children UK on pastoralist nutrition surveys. Mark Myatt was the statistical consultant for the project. He is a consultant epidemiologist and senior research fellow at the Division of Opthalmology, Institute of Opthalmology, University College London. His areas of expertise include infectious disease, nutrition and survey design. Myriam Ait Aissa is the research manager at Action Contre la Faim- International Network (ACF-IN) since 2007. Previously, she worked as a research manager on food security issues in North Africa, South America, Canada and in research management. Nuria Salse is the Nutrition and Health Advisor for Accion Contra el Hambre (ACH) (Action Against Hunger, Spain). Previously she spent several years working on nutrition and medical programmes in Angola, Guinea Conakry, Niger and Argentina. Camels at a water point in Kidal. The authors would like to acknowledge ACF-International Network for financial and managerial support, ACF-Spain for hosting the project in Mali and the peer review group for reviewing the method and providing information on pastoralist communities: Andrew Hall (Westminster University, UK), Phil McKinney (Consultant), William Kalsbeek (University of North Carolina, USA) , Jon Pedersen (Institute for Anvendte Internasjonale, Norway), Fiona Underwood (Reading University, UK), Tina Lloren (Save the Children USA), Francesco Checchi (London School of Hygiene and Tropical Medicine, UK), Megan Deitchler (FANTA), Andre Briend (WHO), Chris Leather (Oxfam GB), Claudine Meyers (Oxfam GB, Kenya), Orla O’Neill (Concern, Ethiopia), Grainne Maloney (FSAU, Somalia), Peter Hailey (Unicef, Kenya), Filippo Dibari (Valid international), Lio Fieschi (Valid International), Fabienne Nackers (MSF Belgium), David Crooks (Tear Fund). The authors also acknowledge the survey team and ACF administration in Kidal, Mali and the communities of Kidal for participating in the survey. This article describes a new survey method for assessing acute malnutrition in nomadic pastoralist populations, including a case study from Mali. The work presented here was commissioned by Action Contre la Faim-International Network (ACF-IN) and took place between May 2007 and June 2008. The research aimed to identify a novel method to assess the nutrition condition of pastoralist communities in countries where ACF operates: Mauritania, Burkina Faso, Mali, Niger, Chad, Sudan, Ethiopia, Somalia, Uganda, and Kenya. Pastoralist populations are vulnerable to shocks that result in nutrition risks, e.g. drought, animal disease, market disruption and closure of borders. However, the lack of a suitable sampling method for pastoralist surveys has contributed to the omission of pastoralist populations in emergency response and development programmes. The two main challenges in surveying pastoralist populations are: • Case definition for wasting (the usual weight -for-height (WH) based case definition has returned higher prevalence’s of malnutrition than Mid Upper Arm Circumference (MUAC) in pastoralist children over 24 months of age) 1 . 1 Myatt, M, Duffield, A, Seal, A, and Pasteur, F. (2009). The effect of body shape on weight-for-height and mid upper arm circumference based case-definitions of acute malnutrition in Ethiopian children. Annals of Human Biology. Also see: (2008) Effect of body shape on weight-for-height and MUAC in Ethiopia. Emergency Nutrition Network. Field Exchange 34. 2 (2005). Measuring Mortality, Nutritional Status and Food Security in Crisis Situations: SMART METHODOLOGY. Version 1 UNICEF and USAID 3 A spatial sampling method that uses a systematic spatial sample from a defined geographic area. 4 Myatt, M, Feleke, T, Sadler, K., and Collins, S (2005). A field trial of a survey method for estimating the coverage of • Selecting a representative sample in an area with a mobile, low density population for whom there are few reliable data on population size at the community level. Existing survey methods and their limitations in pastoralist settings Most surveys use a two-stage cluster sampling method, e.g. 30 by 30 cluster surveys and SMART surveys 2 . Both methods use primary sampling units (PSUs) selected using Probability Proportion to Size (PPS). This weights the sample according to community size, favouring large communities but does not ensure a geographically representative sample. In pastoralist areas, community-level population data are not available and hence the PPS method does not work. Furthermore, mobile communities (troupes) change size and composition throughout the year and may get smaller in crisis conditions as troupes disperse in search of scant grazing resources. Any official information is likely, therefore, to be out-of-date at the time of the survey. The Centric Systematic Area Sampling (CSAS) 3 approach has been used in estimating the coverage of feeding programmes 4 and for wide-area mapping of trachoma prevalence 5 . selective feeding programs. Bulletin of the World Health Organization 83, 20-26 5 Myatt, M, Mai, NP, Quynh, NQ, Nga, NH, Tai, HT, Long, NH, Minh, TH, and Limburg, H (2005). Using lot quality assurance sampling (LQAS) and area sampling to identify priority intervention areas for trachoma control activities-Experiences from Vietnam. Bulletin of the World Health Organisation 83, 756-763 6 ACF (2006). Enquete nutritionelle et de mortalite. Commune de Kidal, Mali 16-27, Dec 2006 7 Vincent, E, and Salse, N (June 2008). Methodology for a nutritional survey among the nomadic population of northern Mali. Emergency Nutrition Network. Field Exchange 33, 14 Trials of the use of CSAS and ‘snowball’ sampling in retrospective mortality surveys are currently underway. The CSAS method has been adapted for nutrition surveys in pastoralist areas, for example in Mali in the same location as this field test 6,7 . Although addressing some of the problems of PPS methods, the main problem with CSAS is that it does not help the survey teams locate the mobile population and hence a lot of time is spent locating troupes. Development of the new method The new method was developed through a peer review process and designed to meet the criteria listed in Box 1. The peer review group were experts in the field of pastoralist society and Box 1: What are the requirements for a new method? The follow requirements were considered essential to define a new method: 1. It should be a general method that can be adapted to the field situation using information gathered locally. 2. The sampling method should not require population data at the start and should not require knowledge of the location of populations ahead of the survey. 3. The method should be straightforward and efficient to conduct in the field. 4. It should be representative of the whole population – even remote communities. 5. An unbiased estimator should be used. 6. The precision should be predictable across different sample sizes and be similar to that obtained by conventional cluster sampled surveys in sedentary rural populations. 7. The case definition used should be appropriate for pastoralists and a good predictor of nutritionassociated mortality. 30
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