Issue 35 Editorial

In this issue of Field Exchange, there are two themes which previous editorials have not addressed - sustainability of interventions and how markets can create, as well as be used to respond, to emergencies. We also revisit one 'old chestnut' - namely the rich vein of innovation that runs through our sector.

Use of the word 'sustainability' in an emergency context always needs qualification and nuancing. Are we talking about sustainability of capacity, resources, demand for services, a product or institutional sustainability? In the most acute crisis, where high levels of external international support are needed immediately, it may be really difficult to think about and implement activities that can be sustained post-emergency. In slower onset crisis or chronic emergencies, it should be more feasible. However, the donor environment may be such that with all the will in the world, implementing agencies can only undertake activities and projects within predefined time lines and budget cycles. Not only does this mean that projects are implemented over too short a period to achieve sustainable outcomes, but there is little understanding or knowledge of how long these outcomes or achievements can be maintained once the 'externally' implemented intervention is over.

A number of pieces in this issue relate to sustainability of interventions. The 2008 Humanitarian Response Index (HRI) report recently published by DARA (see research section) confirms a perennial challenge in the humanitarian sector - how better to link relief to recovery and long term development, and strengthen the resilience of populations affected by crises. The report states that humanitarian agencies often struggle to find appropriate means to achieve a balance between meeting short term needs and laying the foundation for recovery and development. The HRI findings show that some donor policies and procedures can accentuate the gap between relief, recovery and development, rather than facilitating more integrated and harmonised efforts. Similarly, donor procedures can facilitate or impede efforts effectively to engage local communities in defining and implementing programmes that meet their needs.

The field article written by Gwyneth Hogley Cotes describes efforts to scale up and integrate community therapeutic care (CTC) services within existing health services in Malawi. The authors describe numerous challenges and the key role played by the CTC advisory service that, once established, provided the institutional support and constancy necessary to ensure a degree of success. A Food and Agricultural Organisation (FAO) evaluation of the Food Security Assessment Unit and Nutrition Information Project in Somalia found that sustainability of the project (that is now in its fifth phase) is vulnerable, given the substantial resources required to maintain the systems. The evaluation concluded that an exit strategy is needed that foresees the handover of at least some of the activities to local stakeholders in the mid to long term. Recommendations for achieving this include giving more voice to the different Somali actors in the project steering committee, giving preference to partnership with Somali national or sub-national entities even if these are weak compared to international non-governmental organisations, and reducing costs as much as possible so that eventual transfer is eased.

Sustainability is also an important issue for the private sector. A field article by Nutriset explores their experience of 'social marketing' of a ready to use micronutrient supplement in Niamey, Niger. Sale price must cover direct and indirect costs if the product is to be manufactured locally. Nutriset has financed the setting up of the distribution network, training and the large awareness communication campaign. This expenditure has been vital for kick-starting the process - however it is not known whether demand can be sustained without this type of expenditure and whether private producers can absorb these costs or will need to pass them onto the urban poor who are the main target group.

A news piece on the recent World Health Organisation expert collaboration on management of moderate malnutrition in children under five years of age highlights the fundamental issue of the affordability of new products coming onto the market. While many of these new products may have considerable nutritional advantages compared to the types of fortified blended foods used in the past, their cost and therefore the sustainability of their provision, is an unknown - especially in relation to government spending capacity and priorities. Similar issues apply to the role of ready to use therapeutic foods in community-based management of acute malnutrition and scaling up these programmes. It is notable that there has been no modelling of least developed countries government capacities to support provision of these types of product on a large scale over the long term, or discussion of whether the international aid community would be prepared to subsidise such interventions indefinitely.

While previous editorials have highlighted the importance of understanding market behaviour from an early warning perspective, we have never turned the spotlight on the role of the market in creating nutritional crises and how markets may be used to respond to crisis. This issue of Field Exchange carries a number of pieces about the cause and effect of the current food price crisis, as well as possible responses.

Variety of grains for sale at the Iron Market in Port-au-Prince, including American white rice.

According to a recently published ALNAP paper, summarised in this issue, food prices have increased by an average of 52% between 2007 and 2008. The ALNAP paper aims to assist those agencies undertaking operational relief and recovery work in the context of high food prices. It provides a framework for analysing the problem and designing a response. The Centre for Strategic and International Studies (CSIS) launched a task force on the current food crisis. Its report cites a number of root causes of the crisis. These include soaring global energy prices, rise in the production of bio-fuels based on food grains, demand for cereal grains outstripping supply, bad weather, and gross under-investment in agricultural production and technology in the developing world. Other factors singled out for blame are the agricultural and trading subsidies and tariffs that create grave distortions, disadvantaging producers in poor developing countries, and an antiquated international system of mobilising and deploying food relief that slows the response to emergencies and imposes unacceptable costs and inefficiencies. The report contains a number of recommendations to address the crisis, including a modernisation of emergency assistance and a re-focusing of US trade policy on promoting developing country agriculture.

A paper by FANTA deals with the underserved area of humanitarian interventions amongst urban populations. The authors examine the growing trend in urban crisis - which is often mediated through market distortion and hyper-inflation and the various urban specific interventions to address food and nutritional crisis. Two key highlighted interventions involve market channels - market assistance program mes and support to national strategic grain reserves.

A field article written by Lili Mohiddin from Oxfam and Mike Abu from Practical Action describes a newly developed emergency market mapping and analysis tool and the experience of applying the tool following tropical storms in Haiti. The tool allowed for sophisticated analysis of market conditions leading to highly nuanced recommendations regarding interventions in timber and bean markets. The tool can be used by non-specialists and can help determine the appropriateness and optimal design for a broad range of response options including cash transfers.

This issue of Field Exchange has its usual fair share of new and cutting edge programming initiatives. At a time of deepening gloom over the global economic downturn and our sleepwalking into environmental catastrophe, successful innovation and problem solving in our sector serves to maintain some degree of optimism and sense of progress.

A field article by Action Contre la Faim (ACF) describes their experience of implementing a new survey method for assessing acute malnutrition in nomadic pastoralist populations. The sampling method can be used for collecting information on many different variables in addition to malnutrition. In particular, it gets around problems of selecting a sample in an area with a mobile, low density population for whom there are few reliable data on population size at the community level.

The Italian NGO COOPI (Cooperazione Internazionale) has contributed a field article from the Democratic Republic of the Congo (DRC), which describes another take on estimating coverage of CTC programmes. Having found the centric systematic area sampling (CSAS) approach to be too time consuming and biased when there is poor mapping detail available and recent population movement - both problems they encountered - COOPI developed a modified approach involving GPS, which they employed in Goma. This approach appears to be quicker and more accurate as the first 'mapping' phase freed up the survey team, allowing them to focus their energies on actually collecting the data.

A paper by the Alchemy project summarises lessons learnt in implementing micro-credit and other loan programmes for long term refugee and displaced populations. Such interventions have not been widely applied but may have an important role in certain refugee contexts.

Finally, a word on our own piece of innovation. We would like to announce the launch of the ENNs online forum, en-net, funded by USAID/OFDA. It will enable field practitioners to pose urgent and challenging questions they face on emergency nutrition/food security programming, and so access a wide range of experience-based and expert advice that is not reflected in standard guidelines - a sort of interactive Field Exchange. As we launch this initiative, we welcome feedback on the facility and look forward to the questions and debate that materialise and that may well feature in future issues of Field Exchange.

Jeremy Shoham
Editor

Any contributions, ideas or topics for future issues of Field Exchange? Contact the editorial team on email: office@ennonline.net

¹Development Assistance Research Associates

²Food and Nutrition Technical Assistance