Report of informal meeting on Nutrition in Emergencies Dhaka, Bangladesh (2011)

By Philippa Young, Emily Henderson and Agathe Nougaret

Philippa Young is Emergency Food Security and Livelihoods Adviser for Oxfam GB

Emily Henderson is Emergency Food Security and Livelihoods Adviser (Market Lead) for Oxfam GB

Agathe Nougaret is the Urban Coordinator in Haiti for Oxfam GB

This article draws heavily on an Oxfam case study1 written by Philippa Young and Emily Henderson and edited by Laura Phelps and Carol Brady, from Oxfam GB. More programme details have been added in this article by the authors, with thanks to Gabriel Tobias and Laura Phelps, Oxfam GB for their help in the process.

This article describes the nature and short term impact of activities by Oxfam to aid economic and livelihood recovery in the immediate aftermath of the Haiti earthquake in 2010.

On 12 January 2010, an earthquake measuring 7.0 on the Richter scale struck Haiti. Approximately 3.5 million people resided in areas directly affected by the earthquake, which led to the death of 220,000 people. As a consequence, 1.5 million people were initially displaced internally in the metropolitan and rural areas. The earthquake also resulted in substantial food insecurity and loss of livelihoods in an already desperately poor country with limited availability of basic services and precarious income earning potential of its poorest citizens.

Assessments and impact of earthquake

Cash for work helped to clear rubble and support public health initiatives

Several assessments were carried out in the immediate aftermath of the earthquake. A rapid Emergency Food Security and Livelihoods (EFSL) assessment was conducted by Oxfam in February 2010 using the Household Economy Approach (HEA)¹. The focus group discussions (FGDs) involved were conducted in each quartier of Carrefour Feuilles in Port-au-Prince (PaP) to determine the differences between the wealth groups and to define vulnerability criteria, access to food, access to income, and other food security indicators. FGD participants were also asked what EFSL interventions would help households from the various wealth groups; activities such as community canteens and support for tradesmen were repeatedly requested.

An interagency Emergency Markets Mapping and Analysis (EMMA)³ assessment was also conducted in February 2010. The EMMA assessment was conducted by various organisations (including Oxfam) over a two-week period. The study focused on the four markets of rice, beans, construction labour and corrugated iron. It found that there was a breakdown in the market chain, particularly around storage, security and access to formal and informal credit. Small retailers and middlemen were the badly affected part of the supply chain with loss of their productive assets. The results of the construction labour survey element showed that there was a shortage of skilled labour in Haiti. Furthermore, many of the skilled labourers had lost their equipment in the earthquake so local availability of skilled labour would not be sufficient to address the reconstruction demand. Overall, the EMMA demonstrated that the markets were functioning well and that cash could be used as a modality for vulnerable households to access their basic needs which resulted in wide-scale cash transfer programmes across multiple agencies.

A woman working at one of Oxfam's canteens that provides a daily hot meal to local people

An Emergency Food Security Assessment (EFSA) was conducted between February and March 2010 and coordinated by the CNSA (Coordination Nationale de la Sécurité Alimentaire). It concluded that the earthquake antagonised the high levels of food insecurity observed prior to the earthquake, increasing the number of food insecure to about 1,281,127 people with 638,118 in PaP, Delmas and Carrefour. This represented 52% of the population, of whom 31% were dependant on food aid or other social support. The remaining 21% were managing to meet their food needs through coping strategies, such as reducing the number of meals and selling off assets. Households with a poor or borderline food consumption increased from 17% to 30% after the earthquake and female-headed household and single parent households, irrespective of their gender, were more vulnerable.

Information on the impact of the earthquake on chronic poverty and coping strategies was largely anecdotal. Poverty was seen to worsen, with people taking out loans just to eat. In Croix des Bouquets, Oxfam staff observed that women were taking on sex work to feed their families. Poverty levels were estimated at 30-50% in PaP and up to 80% in Carrefour.

Wealth groups and income

Prior to the earthquake the very poor comprised 30% of the population of the bidonvilles (shanty towns), and typically had an income of 9,500 to 12,500 gourdes/month. The poor comprised 35% of the bidonville population and had an income of 12,500 to 17,500 gourdes/month. The middle comprised 25% of the bidonville population and had an income of 17,500 to 25,000 gourdes/ month. The very poor had no productive assets, whereas the poor typically had a bicycle or wheelbarrow, and the middle group had a bicycle or motorcycle.

It was generally understood that there were six basic income sources for most households in the bidonvilles of PaP. These were:

• Street hawking: Very poor and poor groups
• Casual labour: Very poor, poor and middle groups
• Salaried employment: Middle and better off groups
• Petty trade/small business: Very poor, poor and middle groups
• Larger businesses: Better off
• Remittances: All groups

Following the earthquake, fewer differences were seen between these wealth groups and all were seriously affected. The poorest groups lost assets and daily labour opportunities. Small businesses were damaged and were affected by lack of customer purchasing power. Oxfam’s challenge was to respond in a way that benefited the most vulnerable while attempting to also build opportunities for economic recovery through a holistic market based approach, in an environment where extreme poverty and lack of livelihoods opportunities had been the norm even prior to the earthquake.

Oxfam programmatic activities

The absence of strong governance in Haiti has led to the birth and development of a vibrant yet largely un-empowered civil society base in PaP. Oxfam had a long history of working with several partners and community based organisations (CBOs) in PaP before the earthquake and sought to build on these relationships in the immediate aftermath of the earthquake in order to forge a sense of harmony and community led programming, to build capacity of partner organisations and to ensure stronger transparency and accountability of Oxfam and partner programming to all stakeholders. It also became very clear that in order to have successful programmes, partners and local CBOs were absolutely critical in order to help Oxfam determine the most vulnerable households and also to help maintain harmony in such a complex and potentially volatile environment.

Based on the various assessments following the earthquake, the overall goal of Oxfam’s EFSL programme in PaP, Delmas, Carrefour and Croix des Bouquets was to contribute to the survival needs and subsequent economic and livelihoods recovery of vulnerable households. In order to achieve this, a multi-tiered approach was designed, tailored to varying levels of need, vulnerability and capacity. This was undertaken in collaboration with local stakeholders to verify vulnerability and the worst affected urban areas. In total, there were 25,253 beneficiary households, or 126,265 beneficiary individuals, of Oxfam’s programme during its first year.

The following activities were carried out during the first 6 months of the programme:

Community canteens for extremely vulnerable households: This project was designed as an immediate food security intervention to provide lunch for all members of vulnerable families over an 8 week period. Selection criteria were agreed in partnership with local actors and targeted those families in desperate need and without other support. These households tended to comprise the elderly, single/women headed households and households with high dependency ratios. A total of 3,662 households benefited from hot food in the canteens as well as unconditional grants of 7,000 gourdes (USD$175) to help them meet other basic needs and prevent debt accumulation. There were 195 canteens scattered in Oxfam’s working areas that provided meals to 80 people per day. The canteens were implemented through existing small street restaurants, operated by often very vulnerable women (‘restauratrices’) who had also been extremely affected by the earthquake with loss of homes, assets and crucially for economic recovery, customer purch- asing power. These women were also provided with grants of 5,000 gourdes ($125) to support them to boost their businesses, fuel-efficient stoves to help them reduce expenditure on charcoal, business management training and nutrition awareness training to help them make highly nutritious meals at the lowest possible prices using local produce available in the markets.

Basic needs grants for very vulnerable households: An unconditional one-off grant of 8,000 gourdes (approximately $200) was provided to support 5,352 households to cover their basic needs, to prevent debt accumulation and to try and recapitalise micro-businesses where possible.

Cash for work (CFW) for the vulnerable but able bodied: Twenty days of CFW provided a source of income to the very poor or poor households with limited skills but with able-bodied members and benefited 5,931 households. A variety of activities were undertaken, including digging drainage canals to prevent flooding in over-populated urban slums.

Livelihoods recovery grants for micro-entrepreneurs: Livelihoods of the poorest in PaP are essentially based on street hawking and minor petty trade. The majority of hawkers lost all their material and accumulated debt. Thus these grants of 5,000 gourdes (approximately $125) were provided to 10,083 households to support them to re-start their small businesses or to invest in something more appropriate.

Support to tradespeople as suppliers of essential services in the community: The design of this activity was based on the initial EFSL assessment where every community asked for support to tradespeople in order to have access to basic services at community level. Grants of an average of $500 were provided to 780 people who had a trade or specialist skills (e.g. plumbers, bakers, welders, builders, etc.) to re-establish their trade and replace lost tools. Activities were targeted at those who had more than 5 to 10 years’ experience in their trade, were operating in the area prior to the earthquake but had lost their capital and equipment, and were willing to restart their trading activity. In Croix des Bouquets, Oxfam also experimented with vouchers for tools through selected stores in collaboration with its logistics team. On balance, it was felt that cash was simpler and allowed more freedom and flexibility to tradespeople in order to recapitalise. Oxfam employed a group of welders to fit out grocery stores in Carrefour and also developed a database of recapitalised tradespeople to share with other nongovernmental organisations (NGOs) who were looking for specific skills such as carpentry, etc.

Support to grocery stores as suppliers of basic goods essential to the community: The design of this activity arose from the EMMA in which it was established that community stores used by the majority of households at quartier level, had been destroyed, resulting in people having to travel further to access their essential food needs and spend more money on transport. This activity targeted 88 grocery storekeepers who had been key service providers prior to the earthquake with high customer bases in Oxfam’s working areas. The support consisted of the provision of a grant of $1000 and a loan of $1000 provided by a local micro-finance institution. Store owners were also provided with business management training to support them with the day to day running of their businesses. Out of the 88 stores, 15 were provided with 20 ft metal shipping containers to replace the destroyed shops. Welders from Carrefour who were recapitalised through the support to tradespeople activity, were employed to make necessary modifications to the shops to enable them to function effectively.

Accountability and coordination

Accountability and partnership structure

In order to respond to the unique challenges of working in such a complex urban environment, Oxfam wanted to engage and operate with and through partners and local civil society as much as possible. Although Oxfam had worked with partners in Carrefour Feuilles for many years, details of these partners were not well managed and accessible to the team responding to the earthquake. Following the earthquake there was a need to have updated information on civil society operations in order to better understand community support structures and vulnerability. The case study of Carrefour Feuilles, PaP in Box 1 details an accountability and partnership structure that operated at the interface between beneficiaries, civil society, Oxfam and partners.

Box 1: Accountability and partnership structure – a case study of Carrefour Feuilles, PaP

Food cooked by Marie Carole Boursiquot, canteen owner, Carrefour Feuilles

In its original EFSL assessment, Oxfam included a question within its FGDs to ask communities to identify those organisations that best represented them and their needs. Results produced a total of over 60 community based organisations, as well as the original five Oxfam partners.

Oxfam hosted an initial meeting to discuss the results of its EFSL assessment and ideas for programme responses and invited those CBOs it was able to contact to attend. During the ensuing discussions and after hearing differing opinions, it became clear that Oxfam would need to forge a clear strategy for working with civil society in order to create an atmosphere of collaboration and transparency for the utmost effectiveness in response to the earthquake.

Oxfam’s Carrefour Feuilles team quickly organised the first ‘accountability meeting’ in order to discuss and decide on programme activities and to design a partnership strategy that would be conducive to programme success. During the first meeting, Oxfam presented the problems facing the area, beneficiary needs, ideas for beneficiary vulnerability and selection criteria and ideas for activities to address needs. There was great debate on vulnerability and a vulnerability mapping exercise of the most affected areas was organised in order to achieve consensus on the most affected areas for Oxfam to operate in. Finally, after lengthy debate, Oxfam, its partners, local authority and CBO representatives agreed on core beneficiary selection criteria for key activities although the methods of selection were more difficult to agree upon.

CBO members felt that Oxfam’s historical partners would not be able to represent their specific communities and social groups and demanded greater accountability be given in selecting vulnerable beneficiaries. In order to address these concerns, Oxfam adopted an inclusion strategy with the agreement of all. Oxfam organised a rapid capacity building session detailing Oxfam’s core values and the importance of the just selection of vulnerable beneficiaries without any bias or discrimination. Carrefour Feuilles was divided into five zones and each of the five Oxfam partners was given the responsibility of supervising the work of groups of CBOs within its operating areas. CBOs and partners were given several days to complete lists of people matching vulnerability criteria in their working areas and were given financial support to cover their administration needs. Oxfam staff rapidly cross-checked 10% of beneficiaries recorded in order to ensure qualification. Whereas most CBOs submitted lists of highly vulnerable beneficiaries, a very few submitted lists with beneficiaries of questionable vulnerability. These CBOs were dismissed from Oxfam’s collaboration list.

Once beneficiary lists had been agreed, the next step was to organize the administration and management of projects. It was clear that Oxfam would not be able to engage effectively with such a large number of CBOs. Implementation of activities was therefore managed by Oxfam partners and the supervision of Oxfam staff, but CBOs were invited to weekly accountability meetings to comment on the effectiveness of operations and to report on any problems encountered in their communities. It became clear in these meetings that civil society did not feel adequately represented in relief programming and discussions became aggressive and volatile. Oxfam needed to think of a new strategy to minimise the complexity of working with so many organisations, but to achieve the right amount of accountability and transparency in its work that would be acceptable to all parties.

It was decided to form a community accountability committee where all civil society actors would feel adequately represented. This committee would act as an intermediary between Oxfam, its partners, civil society in general and beneficiary communities. The committee would have members elected from civil society organisations who were felt able to represent the community at large and to ensure that voices were heard from all levels of society.

Overall objectives were as follows:

• To reduce conflict and foster collaboration for a more constructive working environment between all concerned parties
• To increase inclusion and understanding
• To ensure transparent beneficiary selection
• To increase the visibility of Oxfam and partner activities and improve reputation
• To reinforce local capacity
• To facilitate a programme exit strategy

Oxfam supervised elections of members of ‘Comphare’, the community accountability comm- ittee, and eight members were ultimately elected including two women and onereligious leader who played the role of overall adviser. The committee was set up in a rented office space in Carrefour Feuilles and equipped with donated office equipment. Committee members were provided with stipends to enable them to spend adequate time supervising Oxfam and partner activities and talking to communities and CBOs. Comphare played a key facilitation role in subsequent general accountability meetings and represented community voices to Oxfam and its partners.

In addition, Oxfam had a free call 400 number for members of the community. The phone service had several functions: to provide information or clarification on Oxfam activities, to allow community members to report incidences of gender violence or security incidents, to gather both positive and negative feedback, and to allow community members to register complaints.

Cash coordination group

The Cash Learning Partnership (CaLP)⁴ set up a cash coordination group and was a key coordinating body for all agencies involved in the response. This group initially worked to standardise acceptable daily work rates that had been proposed by the government and then began discussing wider cash and subsequently livelihoods strategies. Oxfam cochaired the cash working group in Port au Prince and took the lead in developing a tool for monitoring and evaluating cash transfer programming in collaboration with other agencies. The objective was to have one inter-agency M&E tool that could be used to evaluate any kind of cash-based programme and encourage inter-agency usage in order to be able to compare results across organisations for similar interventions. Inter- agency coordination on cash transfer programmes ensured cross-learning, ex- change on technical constraints and solutions, strategic thinking and strengthened the efforts of agencies advocating with donors and government for the promotion of good quality cash transfer programmes.

Programme impact

Oxfam conducted a monitoring review in July 2010 to check the results and impact of its programme:

CFW

Overall, 88% of the households had spent all of their income and 11% were able to save some of their income. Money was spent on food (28%), water, fuel, other goods and equipment, as well as health. Overall, 18% of beneficiaries were able to start or restart an income generating activity from the income of the CFW. An average of 11 day’s work was insufficient to support income generation capacity recovery for the beneficiaries. This led to an increase in the number of days of each work rotation to 20 days. Evaluations by other agencies found that even with 24 days of work, up to 90% of the money was spent on food. Recommendations for the minimum number of days for CFW therefore ranged from 36-48 days.

Community canteens

The canteens enabled an increase in the average number of meals per day from 1.6 after the earthquake to 2.1 during the programme (2.6 being the average before the earthquake). However the programme did not manage to support families to reach and sustain their intake before the earthquake; the number of households having three meals per day dropped from 44% during the canteens to 25% after the programme. This is consistent with the fact that households had not yet reached their income levels from before the earthquake and that food remained the main expenditure (22%). Exactly half of beneficiaries considered Feuilles, PaP that the duration of the canteens programme was too short and that it should have lasted around 6 months. Monitoring of the income of restaurant owners showed a substantial increase in the average income of households, from 20% just after the disaster to 40% after the canteens programme. Distribution of fuel efficient stoves also resulted in a 50% decrease in charcoal consumption. Only 36% of the hot food vendors involved in the canteens programme had been able to restart their restaurant by themselves, on average three weeks to one month after the earthquake. The remainder were able to restart their activity as a result of the Oxfam canteens. Nearly half (46%) of the hot food vendors were able to acquire assets or do something that they could not have done without the support received, e.g. reimbursement of debts. Nearly three-quarters (73%) planned to continue with the restaurant activity after the canteen programme. Figures show their increased income was due to a slight increase in restaurant revenue but mainly to a diversification in income generating activities (especially petty trade).

Support to small businesses

Eighty four per cent of beneficiaries of livelihoods recovery cash grants had used at least part of the grant to procure goods and/or equipment to reinforce or start a business and 87% had restarted an economic activity. Grocery stores all became functional but it is still unclear what percentage paid back loans to the micro-finance institution. Tradespeople informed Oxfam that cash rather than vouchers was preferable in order to obtain high quality, low price material of their choice. The vast majority of tradespeople invested in their particular trade and some also used the opportunity to invest in a second small business. Oxfam has not had the opportunity to follow up with these beneficiaries to check the longer-term impact of this intervention on their livelihoods.

Oxfam conducted a second small impact survey at the end of 2010 based on the HEA approach to assess the impact of its programmes. Three households were interviewed in detail on how they had survived since the earthquake, how they had accessed food and income and how Oxfam’s contribution had affected their lives. The broad conclusion was that Oxfam’s work had brought a positive contribution but that households were nowhere near to their pre-earthquake situation and had precarious unsustainable livelihoods. It was found that the value of these households’ debts were around 3-4 times higher than the value of the grants that Oxfam had distributed. Oxfam used this information for advocacy with other organisations in the cash working group in order to allow flexibility to redefine programmes with a higher value of grant and built findings into subsequent proposals.

Lessons learned

Key lessons learned were: It was difficult to differentiate support needed for recovery from disaster and support needed to address poverty. Poverty was endemic in the earthquake affected areas so that humanitarian action required addressing the disaster and the root causes of vulnerability, i.e. poverty. The prog-ramme aim therefore becomes ‘reach acceptable levels of livelihoods’ rather the pre-earthquake status of populations.

In a dense urban context, it is important to have very clear geographical focus and not expand too widely. The EFSL team initially followed the water, sanitation and hygiene (WASH) team in terms of area selection, which meant that financial, human resources and logistics resources were spread very thinly. The resources would have been more effectively utilised if they had been concentrated in fewer areas and grant sizes been higher.

Beneficiary selection processes can be highly politicised and require Oxfam staff to spend considerable time on beneficiary verification. This needs to be factored into the planning from the start. Relationships with mayors and other local authority representatives proved to be complex, especially given the political opportunities afforded through beneficiary selection. Systematic and transparent work with the CBOs and local representatives enabled Oxfam and partners to enforce agreed vulnerability criteria even where relationships with local authorities were difficult.

The ‘markets approach’ – aiming at supporting grocery stores, tradespeople and small restaurant owners to rebuild affected parts of the supply chains and the supply of basic goods and services – was very ambitious in the first phase. It was concluded that there should have been a dedicated market team to allow other first phase activities to go ahead more quickly.

More CFW was required to provide steadier cash injection and improve the chances of economic recovery.

Programmes should prepare for logistical and financial delays, e.g. lack of availability of tools, reduced capacities of finance institutions following a disaster and processing time for payrolls and payments.

Shop owners who had assets damaged during the earthquake were supported to re-stock

Financial institutions lost much of their capacity so it was difficult to make beneficiary payments on time during the CFW programme. Payment systems need to be organised well in advance with a proper evaluation of financial institutions.

Beneficiary payment processes were improved once Oxfam signed its agreement with Unitransfer (cash transfer agency specialised in remittances transfers).

Vouchers production and names verification processes proved to be a challenge and different systems were tested. To speed up the processes, standard approaches could be designed in advance also as part of contingency planning.

Oxfam had very strong relationships with local partners but needed to improve its dissemination of information to the communities. Despite the feedback systems put in place (freephone 400, accountability meetings), beneficiaries said during the monitoring review that they hadn’t received enough information on the activities.

Monitoring and evaluation was integrated late in the implementation process which prevented feeding in of information for phase 2 strategic planning. The pressure to deliver and respond to the enormous and urgent needs at the beginning of the response posed a substantial challenge to launching early M&E.

For more information, contact: Philippa Young, Emergency Food Security and Livelihoods Adviser, Oxfam GB, email: pyoung@oxfam.org.uk and Agathe Nougaret, Urban Coordinator, Haiti, Oxfam GB, email: anougaret@oxfam.org.uk

¹For a link to the original case study: http://www.alnap.org/resource/6999.aspx

²A guide to the HEA approach is available at: http://www.savethechildren.org.uk/sites/default/files/images/HEA_Guide.pdf

³Guide to EMMA and resources at: http://emmatoolkit.org/Haiti EMMA link: http://emma-toolkit.org/wp-content/uploads/EMMA_Haiti_Case_Study_forweb.pdf

⁴http://www.cashlearning.org