Joanna
returned to work with Doctors of the World (DOW) in August 2011 as a medical
evaluator in Dolo area of Ethiopia. It is located on the border of Somalia. Joanna was sent in response to the famine crisis to create a needs assessment plan.
“There are 4 camps in the Dolo area,
including a transit (border) camp. When we first arrived in the region I
focused on getting a broad public health picture of the situation. For the
first days of the assessment, I spent time at the UN base, interviewing the
field managers responsible for health, shelter, and nutrition. From there I
moved onto the camps. After securing the permits, we held daily meetings with
refugee families. I discovered quickly that there were many children and women
who had not received any medical
care. In the transit camp I started my assessment outside the official border
of the camp, it was here that we found thousands of people living rough in the
bush with no shelter. Although they were able to get into the camp twice a day,
hot meals, the sanitation and water needs were enormous.
The water situation was critical. The problem was that the ground on which the
camps have been developed is rock bed that requires special equipment for
drilling, there was no alternative land. The agencies responsible for water
worked very hard to supply the minimum needed for drinking and sanitation, but
it was a difficult task. Many refugee families had less than 8 litres per day
to live on. Everyday we met with refugees who had given up trying to get water
from the tap stands and simply left their water containers in neat rows until
the water might flow again. The most challenging situation is that there were
simply not enough services to meet the needs. Everyone was working at their
maximum but it was simply not enough.
After several weeks in the camps, we
decided that the best use of our resources would be in establishing mobile
health services in the larger camps, to try to shorten the distance between
health care and those refugees who had scant access to services. We also made
the decision to assist the Minister of Health together with the host population
who were under great pressure to balance their own needs in the drought, and that
of the refugees.
After returning to headquarters we put
together a workable plan to put Doctors of the World’s resources where they can
really work – in helping both the refugee and host populations. Aid equity is
always an issue, but it is always surprising when a host population needs as
much help as the refugees that arrive on their borders. My previous medical co-ordination
work in Kosovo, Central Asia, and Darfur were
almost identical. Whenever there is mass migration or people fleeing war and
famine, the health and psycho-social problems are similar. But the worst
situation, for me as a medic, is when we cannot get into the areas where the
conflict is occurring. This is what happened in Kosovo and Tajikistan (Afghanistan).
I
think the future of the famine crisis
depends on continued response from the international community and on
co-ordination
from the ground. It’s always difficult to coordinate so many
organisations and activities and this crisis is no different. I hope
that we are able to get into Somalia
itself as soon as possible to implement programmes for aid there. It is
gratifying to know we are helping on the refugee side, but thousands are
suffering on the Somalia
side. In mass crises such as these, we have to look at options that
involve the
refugees and host populations too. We can’t work in a vacuum or
ethically
implement programmes that institutionalize refugee camps so that they
become
long term communities.”
