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Children in the midst of calamity
DISASTER MEDICINE: ETHIOPIA
Children in the midst of calamity
please give me back my foot so f ever there was a subject I can walk easily." The food aid that did not lend itself to has certainly been a great help generalisation and platito the family. Zuriash and her tudes, disaster is it. There is no father are relieved that they are Lola Gostelow such thing as a "typical" recovering the use of their disaster, or indeed a "typical" limbs and they quote a local saying: "I stop complaining response. As with medicine, however, the art lies in the about not having shoes when I see a man with no legs". process of diagnosis, whereby a clear analysis of root This is one story amid the wider, devastating, impact causes and effects is vital in determining an appropriate of the latest calamity to hit Ethiopia's poor. The course of remedial action. Aid workers and the agencies international response was comprehensive, and Save the they represent are concerned with the health and wellChildren contributed in a number of ways. being of populations and subgroups. In addition, and We provide food aid t o several increasingly over the past 5 years population groups in the or so, aid work is concerned not highlands and extra food only with saving lives and liveliand medical care to malhoods, but also with protecting nourished children; we monitor and supporting the dignity of the nutritional status of children people, as enshrined in the to ensure our programmes United Nations Declaration of remain effective; and we have set H u m a n Rights. up portable food warehouses in So what does this mean in remote areas. practice? Well, to set the scene, However, this relief the following example from one component of our work will only recent, continuing, disaster might have lasting impact if we also help to highlight some of the strive to secure some longer-term terrible difficulties families face in changes in the economic trying to survive a disaster. It is productivity of this area of the story as told and felt by an 11Ethiopia. Much of this effort year-old child. centres on supporting the Zuriash Hassan lives in livestock economy through Ethiopia's highland plateau, restocking of animal herds for where she and millions of others families who have sold or lost were going hungry after a livestock in the drought, and succession of harvest failures. training of animal-health workers Save the Children met Zuriash to undertake basic low-cost and her father Hassan Andage in veterinary care. Agricultural August, 1999, when they were efforts also need to be supported learning to walk again after eating by training government Zuriash Hussan (right) recovering from severe illness a toxic plant that causes paralysis agricultural extension workers to caused by eating a toxic pulse that grows even in (figure). They were aware that work with farmers on improving the pulse, called vetch, could be times of drought farming techniques. poisonous, but it was one of the The rationale of seeking longer-term sustainable few edible plants that survived the drought, and they were solutions to the underlying factors that make people desperately hungry. "We didn't have any alternative", said vulnerable to natural disasters is fimdamental to the Zuriash's mother, Zawde. "Hunger is more painful than effectiveness of emergency response by non-governmental paralysis". After 3 days of eating the pulse, Zuriash felt organisations. Or it should be; but the humanitarian pain in her lower back. She system continues to fail in both highlighting the was on her way to fetch importance and investing in the very initiatives that are water when she fell down. likely to make a real difference. Most disasters are After that she couldn't stand predictable, and natural ones more so than conflicts. They or walk for weeks. are also manageable, if only we were better informed and As a result of the illness, prepared. But, because of the failure to invest strategically Zuriash was teased merciin disaster mitigation and preparedness, non-governmental lessly by local boys. "People organisations like Save the Children will continue to have were saying bad words. to mount emergency response efforts. We will, therefore, Saying that I'm not a full continue to require food aid to support drought-stricken person." The social ostrapopulations living in marginal lands; or to support cism became too much for emergency housing for children and their families with Zuriash, so she tried to little option but to live in shacks on river basins prone to commit suicide. However, floods; or to respond to cyclones that efficiently tear up her mother found the child weak infrastructure. So, rather than giving communities trying to hang herself and and nations the means to manage disasters, we instead managed to intervene. target them as aid "beneficiaries" and save a few lives. Zuriash is improving Where's the dignity in that? slowly and can now walk with assistance. " I ' m praying I thank Kate O'Malley for collecting the case study in August, 1999. to Allah", Zuriash says, "to
I
s 19
T h e Lancet Perspectives • 356 ° D e c e m b e r • 2000
Children in the midst of calamity
please give me back my foot so f ever there was a subject I can walk easily." The food aid that did not lend itself to has certainly been a great help generalisation and platito the family. Zuriash and her tudes, disaster is it. There is no father are relieved that they are Lola Gostelow such thing as a "typical" recovering the use of their disaster, or indeed a "typical" limbs and they quote a local saying: "I stop complaining response. As with medicine, however, the art lies in the about not having shoes when I see a man with no legs". process of diagnosis, whereby a clear analysis of root This is one story amid the wider, devastating, impact causes and effects is vital in determining an appropriate of the latest calamity to hit Ethiopia's poor. The course of remedial action. Aid workers and the agencies international response was comprehensive, and Save the they represent are concerned with the health and wellChildren contributed in a number of ways. being of populations and subgroups. In addition, and We provide food aid t o several increasingly over the past 5 years population groups in the or so, aid work is concerned not highlands and extra food only with saving lives and liveliand medical care to malhoods, but also with protecting nourished children; we monitor and supporting the dignity of the nutritional status of children people, as enshrined in the to ensure our programmes United Nations Declaration of remain effective; and we have set H u m a n Rights. up portable food warehouses in So what does this mean in remote areas. practice? Well, to set the scene, However, this relief the following example from one component of our work will only recent, continuing, disaster might have lasting impact if we also help to highlight some of the strive to secure some longer-term terrible difficulties families face in changes in the economic trying to survive a disaster. It is productivity of this area of the story as told and felt by an 11Ethiopia. Much of this effort year-old child. centres on supporting the Zuriash Hassan lives in livestock economy through Ethiopia's highland plateau, restocking of animal herds for where she and millions of others families who have sold or lost were going hungry after a livestock in the drought, and succession of harvest failures. training of animal-health workers Save the Children met Zuriash to undertake basic low-cost and her father Hassan Andage in veterinary care. Agricultural August, 1999, when they were efforts also need to be supported learning to walk again after eating by training government Zuriash Hussan (right) recovering from severe illness a toxic plant that causes paralysis agricultural extension workers to caused by eating a toxic pulse that grows even in (figure). They were aware that work with farmers on improving the pulse, called vetch, could be times of drought farming techniques. poisonous, but it was one of the The rationale of seeking longer-term sustainable few edible plants that survived the drought, and they were solutions to the underlying factors that make people desperately hungry. "We didn't have any alternative", said vulnerable to natural disasters is fimdamental to the Zuriash's mother, Zawde. "Hunger is more painful than effectiveness of emergency response by non-governmental paralysis". After 3 days of eating the pulse, Zuriash felt organisations. Or it should be; but the humanitarian pain in her lower back. She system continues to fail in both highlighting the was on her way to fetch importance and investing in the very initiatives that are water when she fell down. likely to make a real difference. Most disasters are After that she couldn't stand predictable, and natural ones more so than conflicts. They or walk for weeks. are also manageable, if only we were better informed and As a result of the illness, prepared. But, because of the failure to invest strategically Zuriash was teased merciin disaster mitigation and preparedness, non-governmental lessly by local boys. "People organisations like Save the Children will continue to have were saying bad words. to mount emergency response efforts. We will, therefore, Saying that I'm not a full continue to require food aid to support drought-stricken person." The social ostrapopulations living in marginal lands; or to support cism became too much for emergency housing for children and their families with Zuriash, so she tried to little option but to live in shacks on river basins prone to commit suicide. However, floods; or to respond to cyclones that efficiently tear up her mother found the child weak infrastructure. So, rather than giving communities trying to hang herself and and nations the means to manage disasters, we instead managed to intervene. target them as aid "beneficiaries" and save a few lives. Zuriash is improving Where's the dignity in that? slowly and can now walk with assistance. " I ' m praying I thank Kate O'Malley for collecting the case study in August, 1999. to Allah", Zuriash says, "to
I
s 19
T h e Lancet Perspectives • 356 ° D e c e m b e r • 2000