From the editor

Group of women participating in a focus group discussion

This is another bumper issue of Field Exchange, with eight field articles and just under 20 research summaries. On the one hand, we apologise for the ever-growing volume of our publication and on the other, we are pleased that so many field practitioners want to write up and share programming experiences. There also seems to be an ever increasing volume of research out there that warrants dissemination. Usually a theme or two leaps out at us once we have amassed our Field Exchange content - not so this time, and we have a broad mixture of material for you to read. So for a change, this editorial doesn’t attempt to link articles by themes but instead, simply highlights field articles and research pieces which we feel are of particular interest. Inevitably this will be subjective and we hope that this doesn’t stop you looking at all the contents in this issue.

Four articles get a special mention in this editorial. The piece by Adèle Fox at Concern Worldwide describes a programme to build capacity of multi- sector actors at woreda, kebele and community levels in Ethiopia to deliver effective infant and young child feeding (IYCF) messages as part of the productive safety net programme and encourage social and behaviour change. It went beyond the usual commu- nication channels, engaged and coordinated with community leaders and worked across sectors to address barriers to good IYCF practice - policies around women’s maternity leave were strengthened, agricultural support addressed food insecurity, and support to water and health services aimed to prevent common illnesses. It appears to be yielding sustain- able and substantial improvements in IYCF practices.

Marie-Morgane Delhoume, Julie Mayans, Muriel Calo and Camille Guyot-Bender from ACF- USA have written an article about tackling Konzo in DRC through introduction of cassava retting techniques and improving access to water. This is a nice follow on to a baseline study shared in Field Exchange 41 that found a 1% incidence in the area. ACF-USA used a community outreach and nutrition education and training strategy to get the information across at large scale, coupled with interventions to improve dietary diversification, water access and agricultural process- ing. At the end of the project, households reported soaking cassava for longer periods across the intervention area (critical to reducing Konzo risk). Impressively, the intervention had at least some part in effecting an 84% reduction in incidence of Konzo between 2010 and 2011. The greatest reduction in new cases was observed among the under 5 years age group.

Assessment team assessing wheat yields in Afghanistan (see field article)

An article by Geoff Brouwer describes a compara- tive study of four relief and emergency response activities - Cash-for-Assets (CFA), Goat-for-Assets (GFA), and two Food-for-Assets (FFA) projects - implemented by World Renew (formerly the Christian Reformed World Relief Committee (CRWRC)) in response to the 2011 drought in Kenya. The objective was to gather a deeper understanding of the various modes of asset-exchange and their differences as emergency responses. The authors conclude that while cash transfer programmes may be more effec- tive where markets function, other key factors need to be considered in selecting an intervention including gender participation, beneficiary preference, project ownership, adverse impacts and behavioural responses. The article shows that while there are many similarities between different models of asset exchange, they are not interchangeable and cannot be expected to achieve identical results.

A final article to mention is by Kate Sadler of Tufts University. This is a study that follows on from earlier work about the importance of milk in the diet of chil- dren of pastoralists in the Somali region of Ethiopia. This latest study shows that through targeted live- stock support to milking animals that stay close to women and children during dry season and/or drought (overall a relatively small proportion of the whole herd), milk production and consumption among children is improved, and their nutritional status benefits.

We have a very large section of research summaries in this issue ranging from clinical trials of food products to reviews of the whole humanitarian system.

One recent study examines the effect of including a lipid based nutrient supplement (in the form of a Ready to Use Supplementary Food (RUSF)) with a household food distribution in Abeche, capital of Chad, on the wasting incidence during the seasonal hunger gap. Interestingly, the study found that although the RUSF improved haemoglobin status and linear growth, as well as reducing diarrhoea and fever episodes, there appeared to be no effect on preventing acute malnutrition. Another study by Martha Mwangome and colleagues in Kilifi, Kenya assesses the accuracy and reliability of using MUAC, length for age and weight for length in measuring nutritional status of infants under six months of age. They found that community health workers can be trained to take MUAC, weight and length measure- ments accurately and reliably among infants age <6 months but that length-based z score indices (length for age and weight for length) are the least reliable anthropometric measures.

There is also a summary of a recent systematic review on the effectiveness of agricultural interven- tions that aim to improve nutritional status of children. Interventions included were bio-fortification, home-gardening, aquaculture, small scale fisheries, poultry development, animal husbandry and dairy development. The review found that inter- ventions had a positive effect on production and consumption of the agricultural goods promoted, but that there was no evidence of a change in total household income and little evidence of a change in the overall diet of poor people. Furthermore, there was no evidence found of an effect on iron intake or on the prevalence of under-nutrition, although there was some evidence of a positive effect on the absorption of vitamin A.

We also include a series of letters from the World Health Bulletin about corporate sponsorship in the public health sector, specifically relating to alcohol giant SABMiller who received a grant from the Global Health Fund to carry out an education intervention aimed at young adults in drinking establishments in South Africa. The letters reflect divergent views about this type of corporate sponsorship which to some extent, rehearse the same arguments around corporate sector involvement in the nutrition sector.

Another review by HelpAge International and Handicap International quantifies the funding provided by donors to meet the humanitarian needs of two of the most vulnerable groups: older people and people with disabilities. It does so by analysing the amount of humanitarian funding targeted at these two groups through the UN Consolidated Appeals Process (CAP) and Flash Appeals in 2010 and 2011. It is incredible to realise that in 2010 and 2011, only 145 (2.4%) of the 6,003 projects submitted to the CAP and Flash Appeals included at least one activity targeting older people or people with disabil- ities, and 61 of these were funded (1%). Not surprisingly, the authors conclude that if the humanitarian community is to fulfil its commitment to the impartial provision of humanitarian assistance to those in greatest need, it must take urgent steps to address the needs of these two vulnerable groups.

Finally, we have two pieces that address the state of the humanitarian system. A recent ALNAP report presents a system-level mapping and analysis of the performance of the international humanitarian assis- tance between 2009 and 2011. One of the major recommendations in the report is that with the rise of the ‘resilience’ agenda, it is critical that new financing instruments are considered to provide the long-term, flexible financing that these broader non-relief interventions require. These findings are also reflected in a recent Tufts University published paper which explores the relationships between climate change, humanitarian crises, and humanitarian response through a review of published and grey literature. Drawing heavily on the CRED data base, the authors state that over the past 11 years, climate-related disasters have been killing an average of 33,520 people a year, and, as critically, affecting the lives of over 211 million people. The paper goes on to explore the likely impact of climate change based on a number of scenarios. Major challenges identified include the fact that prevention, mitigation, and adaptation policies are not in place, capacity to implement policies is weak and that systematic data collection to evaluate and report response results does not exist. A number of quotes from the conclusions of this report are well worth repeating in this editorial:

“The evidence also suggests that humanitarian operations are no longer synonymous with emergency operations. Most humanitarian assistance today goes into operations that have been running for five years or more. As much as 45% goes into programmes more than eight years old.”

“In these long-term crisis environments, in Ethiopia, Sudan, Afghanistan, Palestine - all environmentally fragile states - a major opportunity is being missed to use aid to transform the way communities and their states develop the necessary economies and gover- nance for the future.”

“The humanitarian aid system evolved as a Western based interventionist endeavour, seeing crises as abnor- mal and responding through exceptional interventions.”

“The old methods of working around government systems, rather than with them, have to be challenged. In many crisis-affected states, aid agencies need to see themselves as long-term partners of the state, providing response services, but must also work to build resilience into livelihood systems and the infrastructure of hazard- exposed populations. They need to view recovery from crisis as a process of change to a more resilient state. Such change will not be easy. The humanitarian response sections of aid agencies have tended to see their work in terms of logistics and the impartial, neutral supply of live-saving aid and have shunned much of the political analysis of the development sector, let alone developed an analysis of complex global processes”.

“International humanitarian aid agencies have grown to become large, multinational organizations, turning over billions of dollars each year and playing a critical role in the creation of international civil society norms. They now resemble major transnational corpo- rations and find themselves increasingly challenged by the risk aversion and inertia that comes with scale and an operational model that is still essentially about orga- nizational control.”

There is much food for thought here. While criti- cism is levied at the humanitarian aid system, it could be argued that the system has developed mainly due to whole scale failure of development actors to include the vulnerabilities and risks of ‘fragile states’ in their operations. Let’s hope therefore that the rapidly emerging resilience agenda proves more than the ‘emperor’s new clothes’ and enables a continuum of approach at country level and within agencies (including donors and their funding mechanisms). One marker of progress might be a new profile of development-orientated partners stepping up to engage in recovery activities especially. On that note, we welcome new faces to the pages of Field Exchange and encourage our seasoned readership to share this publication with your colleagues in other sectors and in particular those working in the development arena.

We hope you enjoy another edition of what is ulti- mately your publication, Field Exchange.

Jeremy Shoham and Marie McGrath

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