Providing better health services for waste workers

Shradha Giri
February 14th, 2012

Large numbers of people in the developing world rely on other people’s waste to make a living. In the Kathmandu valley of Nepal nearly 15,000 people work as waste pickers and 800 more deal in scrap. These are the poorest of the poor, many are women and they suffer discrimination through social exclusion, religious segregation and political marginalisation. Often they have started this work as children and their lack of education, poor health care and low status leaves them vulnerable with few opportunities to improve their lives.

One of Practical Action’s projects in this area aims to improve the living conditions of these workers and to secure them better social protection. One of the initiatives of this project was a health camp in Sundarighat in the Lalitpur District of Nepal, to raise awareness of health and hygiene issues and to provide general health check-ups.

There was a worrying start to the event for Dr. Bishnu Acharya and his assisting staff nurse as initially very few workers came along and those that did were reluctant to share their health problems. One of the health team noticed a group of women chatting by themselves, so she joined their group and started sharing her own experience of pregnancy. Slowly the women opened up and began to tell their own stories and soon they were persuaded to agree to an antenatal check-up and were given information on nutrition and hygiene.

From then on, everything went smoothly and more and more workers arrived. Many of the women also wanted the doctor to check their children and were enquiring about vaccinations. Each person was helped to complete a health questionnaire and it was a relief to learn that none of the waste workers suffered from major illnesses. The most common health problem encountered was worms. Dr. Acharya emphasised the need of deworming each and every patient. A couple of women had high blood pressure and were advised to consume less salt and fried foods.

Practical Action’s team has put together a check list of what should be provided when running such health days:

1. A comprehensive list of available over the counter medicines
2. Plenty of deworming medicine
3. Vitamin supplements (especially Vitamin B complex) as many of the expectant mothers lack a balanced diet
4. Rehydration salts
5. Contraceptive advice and condoms
6. All free government vaccinations, including polio, for newborns and children

The success of the day ensured that it will be repeated and on the next occasion it will be organised in collaboration with government local health staff. Information to be provided will include a health and hygiene video and government illustrated booklets on safe sex and contraception and basic health issues.

The medical staff learned a great deal about communicating with people who have little experience of health services. They are now better able to put people at ease so as to extract the patient’s medical history, which is vital for a correct diagnosis and treatment.

Making markets work for the poor

Simon Trace
January 30th, 2012

I returned from a visit to our Nepal programme last week and so thought I’d use my next couple of blogs to provide some news from there.

Woman selling milk to a collection centre in Nepal

In a previous blog I have talked about our work with dairy farmers in Nepal – helping small farmers increase milk yields through improved animal health and nutrition. In Nepal there is, in theory, a huge opportunity for small farmers to earn income from milk sales as there is a national ‘milk deficit’ with very large quantities of both fresh and powdered milk being imported from India to meet the demand of urban centres.

For increased yields of milk to lead to higher incomes for farmers however, improved technology and technical knowledge is only part of the changes that have to occur. The technical side of ensuring access to improved feedstock, the services of vets, cooling facilities to allow milk from lots of small farms to be bulked up and stored until collection by dairy processors etc is all very important. But often there are other problems in the way market chains work which can prevent small producers from realising the potential value of their produce. That is why Practical Action works not just on the technology but also on making markets work for poor people.

I saw an example of the latter on my first day in Kathmandu, when I attended a seminar on barriers to small holder farmers’ engagement in the dairy market, hosted by Practical Action. It was held under the auspicies of a Practical Action dairy project (funded by UK AID) and was part of the process of bringing key market actors from across the dairy market chain together to discuss policy blockages to further expansion of smallholder dairy production. The seminar was attended by about 100 people including small farmers, private sector dairy processors and government officials. The latter included the Minister for Agriculture, the Permanent Secretary for the Ministry of Agriculture and the Director General of the Livestock Department of the Ministry of Agriculture. A representative of the UK’s Department for International Develoment was also present as a speaker.

The workshop was good evidence of our Nepal office’s convening power, in this case bringing together and facilitating discussion amongst the whole range of different players that make up the dairy market chain in Nepal. The first part of the morning included speeches by the main guests and a key note speech identifying some of the main problems in the dairy market chain today that hamper dairy businesses from operating efficently and which prevent small farmers from obtaining the best value for their milk. The principle problems listed were: limitations on the ability to improve the quality of livestock (because of an embargo on cross border cattle movement from India and very limited artificial insemination facilities), limited access to credit for small holder farmers, and the depressing effect on supply of the price fixing system used by the Government’s Dairy Development Board.

The meeting went on to 4pm in the afternoon, 3 hours after its due closure time, because of the intense interest of the participants in the discussion. One outcome was that government officials agreed to look into the possibility of an official visit to India to, amongst other things, hold discussions on cross border cattle movement.

This sort of meeting is part of a participatory market mapping and facilitation process that Practical Action has developed over the past few years to help all actors in a market chain better understand how a market works and what could be done differently to improve the value to all participants but, in particular, to make markets work for the poor. For more information see our website at: http://practicalaction.org/markets-2

Farmer to farmer knowledge sharing

Amrit Bhandari
Kathmandu 44600, Nepal, Kathmandu
January 17th, 2012

The mission of Practical Answers is to contribute to the improvement of livelihoods, by providing knowledge services and facilitating sharing of technical knowledge relevant to development processes and poverty eradication.

Based on this mission, Practical Answers in Nepal, in partnership with READ Nepal, has been working with communities to establish knowledge nodes - places where people can get information, such as a room in a village that has an internet connection.

There are more than half a dozen ways of providing technical information people, particularly to the poor communities who can use such information and knowledge to improve their livelihoods.

Farmer to farmer knowledge sharing is one such model. People who are skilled and trained through Practical Action’s projects respond people who contact Practical Answers with an enquiry. The limitation is that only enquiries related to the training will be responded through the farmers to farmers model. However, there are other responding models such as interactions between community and experts, animal health camp, radio programme, linking the enquiries with related government agencies in district and local level to respond the broader enquiries.

Market Access for Smallholder Farmers (MASF) is a project Practical Action has been implementing in four districts of Nepal.

Nirmala Bogiti and Shanti Parajuli have been trained through the MASF project in basic animal management, fodder/forage management and they have participated in workshops on livestock health.

In the process of collecting enquiries through Practical Answers in Chitwan and Nawalparasi we found some of the communities wanted to know how they can keep their livestock healthy, for example, how they can prepare balanced diet.

Based on the enquiries, knowledge nodes organised a- farmer to farmer knowledge sharing practical interaction in a few communities to test how effective this model would be to implement in other communities.

Nirmala and Shanti shared their knowledge and taught Practical Answers enquirers how they can prepare mineral blocks using local resources, what the ingredients are and what the benefits are for the livestock to keep them healthy.

The model was very effective as enquirers directly ask many more questions related with dairy farming with the trained and skilled farmers like Nirmala and Shanti. Nirmala and Shanti are among the successful farmers of the MASF project who have significantly increased their income through dairy farming. While they shared their experience and stories on how they became successful farmers, they inspired the enquirers who asked for information on dairy farming and also received practical information from them.

The knowledge sharing process doesn’t end here. While farmers received knowledge from leader farmers, they apply it for themselves and pass on to other farmers  who are in need for such knowledge. While Karnakhar Acharya from Nawalparasi received practical knowledge to prepare mineral block from Nirmala then he has been supporting other farmers in his communities who ask him about the mineral block.

Bermuda Triangle of economic empowerment

Read my review of the conversations, sharing and  learning that went on at the SEEP Network Annual Conference and find out what the Bermuda Triangle of economic empowerment is all about.

I presented Practical Action’s Bangladesh work in one of the Vulnerable Populations workshops. Alison Griffith and Lucho Osorio were also at the conference, presenting  lessons of engaging with the national level private sector in Nepal and managing complexity in market development, respectively.

Nepalese couple defied the odds

Shradha Giri
December 14th, 2011

Nirmala Bogati and her husband Shyam Bogati are a sought after couple in their village. Both Nirmala and Shyam are dairy farmers from Chitwan District and are confident that they can earn better in their own village than their neighbours who often resort to foreign employment.

Recently, Nirmala and Shyam shared their story of success to Radio Audio’s Khulduli.com programme.  Through khulduli.com their stories were broadcasted to 35 districts in Nepal. This is a story of a regular couple who defied odds and ditched foreign employment to work on their farm instead. 

Shyam states, “I had been raising cows and selling milk for the past 15 years. I lost four cows in a month and that is when we hit the lowest point in our lives. I thought of going to a foreign country but luckily our future had something better in store for us.”

Nirmala heard about the MASF-Dairy component Project providing series of training sessions on livestock management, shed management, techniques to increase milk production, feed and fodders, mineral blocks as well as practical knowledge on overall dairy value in Nepal. She immediately shared the information with her husband and decided Nirmala would attend the training classes.

“As soon as I attended the classes I was confident I could improve our living standard. My husband and I started growing quality grass for our livestock, we kept our livestock clean, we sought timely medical care, and we provided the livestock with the mineral blocks which helps in digestion and provides essential nutrients. And in time the milk production increased and our income too. In a year we have added two cows which totals to four milking cows. We sell NPR 200,000 worth milk and our net profit is NPR 120,000. Our monthly income is around NPR 20,000,” said Nirmala.

Through the radio programme both Nirmala and Shyam share the importance of home grown opportunities. They also state that they are earning much more and are happy that the whole family is together. Nirmala and Shyam encourage those seeking foreign jobs to work and seek opportunities in Nepal and Shyam hands out his mobile number to those seeking information on good practices of dairy farming.

You can listen to their story at http://www.aradioaudio.com/index.php?pageName=taaza&nid=255

Nirmala and Shyam have shown that if there is a will there is a way out. 

A man’s world: ending violence against women in Bangladesh

I’m a 24 year old woman. I was born in Switzerland, but have spent the rest of my life here in the UK. I don’t have children. I’m not married. And I feel no social or cultural pressure to undertake these things. The geography of my birth means that the choices I make with my life are my own. Not those of my family, or community, or anyone else. I feel safe.

Aroti lives in Bangladesh and is also 24. At the age of 17 she embarked on a marriage which is already over because of the horrendous physical abuse she suffered at the hands of her husband. Now Aroti makes her home with her parents again. And as a single, pregnant woman, she was ostracized by her community.

Practical Action works closely with some of the world’s poorest people, helping them to use simple technology to fight poverty and injustice, building a better, more beautiful world. We have been in Bangladesh’s Magura district since 2007, helping the most marginalised of people – like Aroti – to learn new skills and use new tools to enable them to earn proper livings.

Aroti was already a talented dressmaker when we met her so we helped her to buy a sewing machine. This tool meant Aroti was able to sew her way to a better life. She developed relationships with local shops and established a strong foothold in the local market. We trained Aroti on business skills such as accountancy and marketing. Now her business is more successful than ever, with her monthly income as much as £32. She is happier and safer now than she has ever been. Her economic empowerment means that for the first time she has control over her own body and her own life.

Of course Aroti is just one person. According to the UN, 47% of Bangladesh’s women endure domestic violence, rape and even murder due to the dominance of the patriarchal systems. There are so many more women who need the skills and tools to make independent livings so they are not compelled to remain in dangerous relationships. But it doesn’t just stop there. We need to advocate at the very highest levels – until the world is a place where violence from women is socially unacceptable. Where rape of a woman by her husband is illegal everywhere. A world where it’s as safe to be a woman as it is to be a man.

Jargon busting! How do you communicate research?

katiewelford
October 11th, 2011

For development practitioners, words and phrases like ‘value chains’, ‘bioenergy’, ‘gender and equity’ roll off the tongue, but for a lot of us it is not always clear what is meant by them. As I discussed in my last blog post, one of the challenges of working on the PISCES project is trying to reach (and interest) wider audiences when you are dealing with jargon.

One of the themes of the PISCES project is to ‘strengthen capacity’, which is really about working with individuals or groups to build their skills and knowledge in bioenergy (energy from biomass: think wood and charcoal). Through our partners at the University of Edinburgh and the University of Dar es Salaam, Masters and PhD students research a number of technical and social issues relating to bioenergy. You might call this ‘Training tomorrow’s bioenergy leaders’.

In early August I spent a few days up in rainy Edinburgh listening to some fantastic student presentations on PISCES and PISCES-related project. Their Powerpoint presentations, with some audio attached, can be viewed here. Whilst these are excellent presentations, I am always aware that these might not be the best way to engage people who don’t know a lot about the topic.

I don’t know about you, but with an arts and social science background, Powerpoint does not scream ACCESSIBLE to me! So I also worked with a smaller number of students to create some digital slideshows and podcasts. Below is one I made with Alannah Delahunty, and her research on ‘Gender in the Charcoal Value Chain in Western Kenya’.

Take a look at the 5-minute slideshow and let me know what you think: is this a good way of introducing people to a topic? Have you learnt anything new?

For more in-depth publications from PISCES and our international research on bioenergy, visit www.pisces.or.ke

This also ties in with Practical Action’s work on market mapping.

Microfinance empowering drought-hit poor

Gemma Hume
Isiolo - Mandera Rd, Mandera, Kenya, Mandera
August 12th, 2011

I’ve never really been interested in finance. Just the very mention of “savings and investment”, “stocks” or “retirement planning” makes my eyes glaze over.

So I surprised myself with the excitement I felt about a Practical Action finance initiative funded by animal welfare charity The Brook.

In fact, it’s the project I am most passionate about in drought-hit Mandera Why? Because it’s a fantastic example of how we’re building the capacity of people to generate their own income from livelihoods; how we’re helping them become self-sufficient so they can avoid having to depend on hand outs to survive.

What it’s about:

Working with the Equity Bank, local authorities and other organisations, we’ve just launched the Equine Savings and Investment Group, a pilot group lending initiative for donkey owners. These people are mainly pastoralist ‘drop outs’ – they’ve lost their livestock and their way of earning a living.

How it works:

Practical Action recommends a group of up to 15 donkey owners to the bank, pays the application fee, interest and insurance. Individuals pay a minimum of one Kenya shilling into a group account. The collateral of the group acts as a security net for the bank so if anyone defaults on loan payments, it can take the money from the group.

The members can then apply for loans to improve their livelihoods. These applications have to be approved – ensuring the money will be used in the best possible way, rather than just to buy non essentials. One example is buying more donkeys and carts which can be hired out to people who can’t afford them.

But that’s not just it. We’re also doing this:

At the same time, Practical Action works with the community to identify and then train people on alternative income generating activities like donkey powered transport for firewood, water and crop produce, or becoming donkey cart artisans and harness makers.

What the donkey owners say:

So far 56 groups have been set up. It’s early days but donkey owners are excited about the difference this initiative could make to their lives.

One of them said: “We’re grateful for the assistance we’ve received in empowering us to strengthen our livelihoods. This provision is a good financial solution to our problems. We can raise our income and our quality of life. We feel that now we have a very bright future.”

If this is successful, it could be replicated all over Kenya. Watch this space!

Text symrabies to 4321

“Check this out”, Deepak, Nepal’s Head of the Markets and Livelihoods Programme called over to me. When I came over, he had his phone in his hand, texting ‘pai symrabies’ to 4321. Immediately he got a text back: ‘Aggressive, drooling, choking sound, sensitive to noise and movements, lack of appetite and excessive sleeping. SMS “treatrabies” to 4321 for treatment options’.

Of course we texted ‘treatrabies’, and we got this message back: ‘Isolate animal. Do not touch or come in contact with Saliva. Call vet or para vet. SMS “vet” and your location number. E.g. “vet1” if you are in Dullu’.

The next text had a couple of names, addresses and phone numbers.

This text messaging service is part of a new project in Nepal called Access to Information (A2I). You can see that it’s new because Deepak’s demonstration is not completely ready. Shortly the service will have its own dedicated number and once that’s set up, you won’t have to put ‘pai’ in front of your requests. That just stands for ‘Practical Action Information’ and is required because 4321 is Focus One’s number. Focus One is the company behind text message horoscopes and dating compatibility tests in Nepal. Who better to partner with to deliver a virtual encyclopedia of information for agriculture, livestock-rearing, and foraging of non-timber forest products to the poor!?

Each text costs 3 Nepali Rupees, that’s about 2 pence. Of that, 2 rupees go to NTC, the national mobile network. Half a rupee goes to Focus One, and half a rupee comes back to Practical Action. The reason for that half rupee coming back to us is that we hope the demand for the service will grow enough to pay for a permanent person to keep the system up to date. So this model is built for sustainability.

And it’s built for scale. The service works anywhere in the country.

Practical Action Nepal is drawing on its network of experts in agriculture in the government and private sector to feed the system with up-to-date information about market prices, disease outbreaks, local weather forecasts and much more.

A lot of this information is already out there, publicly available, but the problem is that poor people out in the hills and mountains, who could really make use of it, can’t get hold of it. Like everything Practical Action does, the need came before the idea. Practical Action Nepal has drawn on a wealth of analysis conducted with the participation of poor farmers to find out what their biggest problems are. Lack of basic information is one of the biggest issues.

All well and good, but what happens if you don’t have a phone. Good question. Although Nepal’s phone ownership has been growing nearly exponentially in the last few years, it’s still fairly low compared to other countries, including those in Africa. Furthermore the distribution of phones is heavily weighted towards the urban population, and in rural areas towards those in the service sector. That’s why for A2I, this mobile text messaging service and its sister Voice Messaging (VM) service are not intended to reach the last mile.

(The last mile is part of Practical Action’s development-speak. It means that last distance (spatial, economic, social…) between those doing ok in difficult situations, and those that aren’t. Reaching those that aren’t – that last mile – is what Practical Action is all about.)

A2I’s text messaging and VM services are designed for local animal health workers, agricultural service providers and community forest chairpersons to access useful information. In many places these are the only people reaching the last mile and providing them with advice. A2I’s services are designed to help them provide the last mile with much, much better, up-to-date, advice.

Lollipops for cows

A locally appropriate, low cost answer to cattle malnutrition …

Cow licking a mineral bloc, Chitwan, Nepal

1. Take 1 kilogram of that red mud that’s at the back of the homestead;

2. Dry it out in the sun for a couple of days and pound into a powder;

3. Roast 10 egg shells (just the shells – eat the contents youself with your family), pound into a powder and add it to the red dirt;

4. Mix this with around 1 kilogram of regular salt, the stuff you can buy at the shop a few doors down;

5. Add 1/2 a kilogram of flour to bind the mixture;

6. Finally pour in some water as required until the mixture holds together and can be shaped into blocks. Shape them into donut shapes (making sure you leave a hole in the middle of the block);

7. Leave to dry for a week in the shade, then another week in the sun until hard;

A local breed cow using a mineral block in Chitwan, Nepal

8. Use the hole in the middle to string the block up in your cow-shed. Make sure that your cow can reach the block at a stretch, but not easily. String up one of these blocks for each of your cows.

That’s how you make a Nepali Khanij Dikka, a mineral block. It’ll cost you around 30 Nepali Rupees (22 – 28 pence) to make a block that weighs 2.5 kilograms. That cost comes from 14 – 16 Rupees for the salt and 13 – 15 Rupees for the flour. Obviously the red mud is free, and you’re probably eating eggs so those shells are a free by-product. Each block will last one cow for about a month.

Your cows will natural lick the mineral block when inclined, taking in iron from the red earth, calcium and phosphorus from the egg shells, and iodine, sodium and chlorine from the salt. These are all essential minerals necessary for the good health of your cows and so that your cows produce a good quantity of milk that is high in fat!

Thanks to Prakash Poudel, Dairy and Livestock Specialist on the Market Access for Smallholder Farmers (MASF) project, for providing all the technical input for this post!

P.S. Read my recent blog about why Practical Action Nepal is working in the dairy sector and what it is doing to help farmers improve the nutrition of their cows so that they can produce milk of appropriate quality and in large enough quantities to attract commercial buyers.

Some 'improved' breed cows in a model cow-shed