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As a doctor in Sudan, let me tell you: foreign aid saves lives
by Dr. Tom Catena
Aurora Humanitarian Initiative, agencies
| For the last nine years, Dr. Catena – known by locals as “Dr. Tom” – has been on-call 24 hours a day, seven days a week at the Mother of Mercy Catholic Hospital to care for the more than 750,000 citizens of Nuba amidst ongoing civil war between the Government of Sudan and the Sudanese People’s Liberation Movement. Patients have been known to walk for up to seven days to receive treatment for injuries from bombing attacks and ailments varying from bone fractures to malnourishment and malaria. It is estimated that Dr. Catena treats 500 patients per day and performs more than one thousand operations each year |.
As a doctor in Sudan, let me tell you: foreign aid saves lives, says Dr. Tom Catena.
'' My heart sank last week when President Trump announced proposed cuts in the diplomatic and foreign aid budget. The budget suggests cuts in aid to international organisations by 44%, humanitarian assistance funding would drop by 31% and global health programmes would be cut by 25%. While many people think the budget has little chance of passing in Congress, it does, however, provide an alarming sense of the Trump administration’s priorities.
But its not just a US concern. Earlier this month, the Australian government announced it will cut $303m from the foreign aid budget over two years. In the UK, Theresa May’s pledge to continue meeting the UN’s 0.7% aid target was a great relief, although this good news has since been tarnished by the claim that poverty reduction in the world’s poorest countries risks being diluted by the UK government devoting a bigger share of its aid budget to pursuing the national interest.
This comes at a time when the world faces its worst humanitarian crisis since 1945, according to the UN. Twenty million people face starvation without an immediate injection of funds in Yemen, South Sudan, Somalia and Nigeria.
I keenly observe these developments, not as part of the international aid community but as someone who sees the desperate need for aid every waking hour of the day. Since 2007, I have been the only doctor permanently based in Sudan’s Nuba Mountains, home to 750,000 people. It is also a conflict zone. War has raged since 2011 between the Government of Sudan, and the Sudanese People’s Liberation Movement.
The people of this region have suffered beyond belief, with aerial bombardments a daily occurrence for years. Villages and farms have been targeted, forcing the population to flee into the mountains, where they have little or no food. I have experienced the atrocities and hardships of this war, firsthand. I regularly treat up to 400 people a day. Adults and children with horrific burns across their bodies, toddlers with lost limbs due to shrapnel wounds and people suffering from leprosy or malnutrition.
We don’t have access to medical technology. Supplies are limited. We use decades-old treatments and often don’t have electricity or running water. We don’t even have reliable telephones. But I’m always on call, delivering babies, treating cancer, training my staff and, all too often, repairing the wounds inflicted by war, using what few resources we have, and with support from my incredible team.
The bombardments have stopped for now, but the suffering of the people remains. The biggest problem is a severe shortage of food. We are on the border with South Sudan and we suffer the same famine conditions and government forces have blocked the routes for food and aid. It is a truly desperate situation.
The sad truth is that most world leaders and humanitarian organisations have virtually abandoned the people of the Nuba Mountains. Most types of foreign aid are non-existent. I am needed here just as much, if not more so, as I was when I came here in 2007; so is the support of the international community.
Only seven countries meet the 0.7% of global national income target for aid. Countries that should be at the forefront of efforts to prevent catastrophes such as famine and to relieve the effects of drought on some of the world’s poorest people are turning a blind eye. This sends a worrying message that leading economies are no longer interested in being part of efforts to mitigate suffering.
Part of the problem is that the narrative needs to change. Foreign aid has become a politically divisive issue. People assume the money is misspent, wasted on bureaucracy or that foreign aid just doesn’t work.
Of course, the system is far from perfect. In an ideal world, it would not just be about how much is spent to fix the immediate problems, but, rather, about the impact aid has on sustaining stable governments, tackling corruption, protecting human rights and the rule of law. Nonetheless, in the short term, I see what a positive impact humanitarian aid can have. It can literally make the difference between life and death.
There are people doing incredible work around the world every day to help preserve human life. These are not people tied to the international aid system, but people who independently tackle the needs of the most helpless and destitute and do so at great risk.
But individuals cannot tend to the world’s afflicted alone. The international community must provide the resources to help us better serve the people who need our services. At a time when famine is reaching a crisis point in parts of Africa, and countless children are dying of starvation, the need for support from the world’s richest nations is even more critical''. (Published by The Guardian: 28.5.2017)
* Dr Tom Catena is the only doctor in Sudan’s Nuba Mountains; he is the winner of the 2017 Aurora humanitarian prize:
13.02.2018 (UN Dispatch)
“The U.S. State Department and the U.S. Agency for International Development could face deep funding cuts under a budget deal worked out last week that ended a government shutdown, and lawmakers are struggling to find additional funds to plug the gap. The funding shortfall of about $8.8 billion would impose the biggest reduction in resources for the U.S. diplomatic corps and development programs since the 1990s. The funding shortfall for the State Department and USAID affects operations for the current fiscal year, and for 2019.
The budget deal reached last week among congressional leaders and the White House averted a prolonged government shutdown by setting spending levels for fiscal year 2018 and fiscal year 2019. Last year there was bi-partisan Congressional resistance to calls for swingeing cuts in the aid budget (FP:
And So What Does the White House Budget Request… (CNN)
“The Trump administration is proposing sharp cuts to the budget for international diplomacy and aid in its 2019 funding request to Congress. In White House documents and a letter Secretary of State Rex Tillerson wrote to lawmakers, the administration requests $37.8 billion for fiscal year 2019 for the State Department and Agency for International Development, a cut of 32% from 2017 levels. (CNN: Guardian:
InterAction calls for no less than $59.1 billion to maintain U.S. leadership on foreign assistance
WASHINGTON -- On Monday, February 12 the White House released its initial budget recommendations for fiscal year 2019, which proposed a topline of $41.7 billion or a 30% cut to the International Affairs Budget from Fiscal Year 2017 enacted levels of $49.6 billion. In reaction to the proposed cuts, InterAction CEO Sam Worthington said:
“The White House’s budget will do damage to poverty-focused development and humanitarian assistance programs already proven to help save lives. The American people and Congress have consistently supported development and humanitarian spending.”
“United States government investments in the international affairs budget have had an instrumental impact creating healthier, safer and more stable societies around the world. The international nonprofit community works closely with the U.S. government and local partners to successfully address development and humanitarian needs and funding for the international affair budget must be protected,” Worthington added.
InterAction and over 120 international nonprofit partners released recommendations last week that the International Affairs Budget cannot be funded at less than $59.1 billion. This minimum requirement is needed to maintain American leadership on foreign assistance and effectively implement life-saving programs. View the full InterAction Community Endorsement letter:
12 Feb. 2018
In remarks accompanying their annual letter to the public about global development issued by their foundation, Bill & Melinda Gates warned that the proposed Trump administration budget could directly lead to millions of preventable deaths around the globe, due to proposed vast cuts to foreign aid and development funds.
“US generosity: if that goes away, even a 10% cut would mean 5 million deaths over the next decade,” Bill Gates highlighted.
The Trump administration, as it did last year, proposed billions of dollars in cuts to foreign aid, which makes up less than 1% of US spending, in its 2019 budget outline. Last year, lawmakers in Congress from both parties mostly ignored the request, and Gates said he hoped they would again this year too.
He called on Trump not to cut aid to the developing world. “To have Africa be stable, to have health systems that stop pandemics, and to reduce the chance of the army having to go fight somewhere and the loss of lives: these investments, are very, very wise,” said Bill Gates, referencing Donald Trump’s longstanding rhetoric dismissing foreign aid as a wasteful handout to non-Americans.
Melinda Gates added: “If you believe in any form of soft power, if you believe that the world is more peaceful when it is prosperous and low-income nations can build into middle income nations, then you invest in foreign aid. It makes absolutely no sense to us when we see administration budgets come forward and there are huge cuts.”
Melinda Gates also expressed dismay at the administration’s budget “zeroing out” funds for women’s healthcare as it relates to contraception. “You’re leaving women in destitute poverty if you don’t fund contraceptives,” she said. The budget move by the administration follows Trump’s executive order instituting a “gag rule” on US-funded international NGOs providing abortion services.
The Gates foundation is the largest philanthropic organization in the world. It tackles issues related to infectious disease, education, family planning, and women’s rights.
1 Feb. 2018
CDC to cut by 80 percent efforts to prevent global disease outbreak. (Washington Post)
Four years after the United States pledged to help the world fight infectious-disease epidemics such as Ebola, the Centers for Disease Control and Prevention is dramatically downsizing its epidemic prevention activities in 39 out of 49 countries because money is running out, U.S. government officials claimed.
The CDC programs, part of a global health security initiative, train front-line workers in outbreak detection and work to strengthen laboratory and emergency response systems in countries where disease risks are greatest. The goal is to stop future outbreaks at their source.
Most of the funding comes from a one-time, five-year emergency package that Congress approved to respond to the 2014 Ebola epidemic in West Africa. About $600 million was awarded to the CDC to help countries prevent infectious-disease threats from becoming epidemics. That money is slated to run out by September 2019. Despite statements from President Trump and senior administration officials affirming the importance of controlling outbreaks, officials and global infectious-disease experts are not anticipating that the administration will budget additional resources.
Two weeks ago, the CDC began notifying staffers and officials abroad about its plan to downsize these activities, because officials assume there will be “no new resources,” said a senior government official speaking on the condition of anonymity to discuss budget matters. Notice is being given now to CDC country directors “as the very first phase of a transition,” the official said. There is a need for “forward planning,” the official said, to accommodate longer advance notice for staffers and for leases and property agreements. The downsizing decision was first reported by the Wall Street Journal.
The CDC plans to narrow its focus to 10 “priority countries,” starting in October 2019, the official said. They are India, Thailand and Vietnam in Asia; Jordan in the Middle East; Kenya, Uganda, Liberia, Nigeria and Senegal in Africa; and Guatemala in Central America.
Countries where the CDC is planning to scale back include some of the world’s hot spots for emerging infectious disease, such as China, Pakistan, Haiti, Rwanda and Congo. Last year, when Congo experienced a potentially deadly Ebola outbreak in a remote, forested area, CDC-trained disease detectives and rapid responders helped contain it quickly.
In Congo''s capital of Kinshasa, an emergency operations center established last year with CDC funding is operational but still needs staffers to be trained and protocols and systems to be put in place so data can be collected accurately from across the country, said Carolyn Reynolds, a vice president at PATH, a global health technology nonprofit group that helped the Congolese set up the center.
This next phase of work may be at risk if CDC cuts back its support, she said. “It would be akin to building the firehouse without providing the trained firemen and information and tools to fight the fire,” Reynolds said in an email.
If more funding becomes available in the fiscal year that starts Oct. 1, the CDC could resume work in China and Congo, as well as Ethiopia, Indonesia and Sierra Leone, another government official said, also speaking on the condition of anonymity to discuss budget matters.
In the meantime, the CDC will continue its work with dozens of countries on other public health issues, such as HIV, tuberculosis, malaria, polio eradication, vaccine-preventable diseases, influenza and emerging infectious diseases.
Global health organizations said critical momentum will be lost if epidemic prevention funding is reduced, leaving the world unprepared for the next outbreak. The risks of deadly and costly pandemic threats are higher than ever, especially in low- and middle-income countries with the weakest public health systems, experts say. A rapid response by a country can mean the difference between an isolated outbreak and a global catastrophe. In less than 36 hours, infectious disease and pathogens can travel from a remote village to major cities on any continent to become a global crisis.
On Monday, a coalition of global health organizations representing more than 200 groups and companies sent a letter to U.S. Health and Human Services Secretary Alex Azar asking the administration to reconsider the planned reductions to programs they described as essential to health and national security.
“Not only will CDC be forced to narrow its countries of operations, but the U.S. also stands to lose vital information about epidemic threats garnered on the ground through trusted relationships, real-time surveillance, and research,” wrote the coalition, which included the Global Health Security Agenda Consortium and the Global Health Council.
The coalition also warned that complacency after outbreaks have been contained leads to funding cuts, followed by ever more costly outbreaks. The Ebola outbreak cost U.S. taxpayers $5.4 billion in emergency supplemental funding, forced several U.S. cities to spend millions in containment, disrupted global business and required the deployment of the U.S. military to address the threat.
“This is the front line against terrible organisms,” said Tom Frieden, the former CDC director who led the agency during the Ebola and Zika outbreaks. He now heads Resolve to Save Lives, a global initiative to prevent epidemics. Referring to dangerous pathogens, he said: “Like terrorism, you can’t fight it just within our borders. You’ve got to fight epidemic diseases where they emerge.”
Without additional help, low-income countries are not going to be able to maintain laboratory networks to detect dangerous pathogens, Frieden said. “Either we help or hope we get lucky it isn’t an epidemic that travelers will catch or spread to our country,” Frieden said.
The U.S. downsizing could also lead other countries to cut back or drop out from “the most serious multinational effort in many years to stop epidemics at their sources overseas,” said Tom Inglesby, director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health.

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Dramatic deterioration in the humanitarian situation in DRC
by UN Office for Humanitarian Affairs, agencies
Democratic Republic of the Congo
Feb. 2018
The dramatic deterioration of the humanitarian situation in the Democratic Republic of the Congo in 2017 has forced humanitarian actors to launch an appeal for US$ 1.68 billion for 2018, the largest ever funding appeal for the country.
The humanitarian situation has drastically worsened over the last year. A surge of violence forced hundreds of thousands of people to flee. The country is already beset with one of the world’s largest and most complex humanitarian emergencies. Food insecurity and malnutrition have deteriorated. A 30 per cent increase from 2017 year means that now 7.7 million people are left food insecure and over 2 million children at risk of severe acute malnutrition. Girls and women have suffered horrific sexual and gender-based violence. 4.3 million of people are struggling to survive in displacement. Overall, 13.1 million people urgently require humanitarian assistance.
The funding is needed to urgently assist some 10.5 million Congolese people in 2018. Geographical expansion of the humanitarian needs and worsening situations in existing crisis hotspots all require a step change of the response of the international community to address life-threatening humanitarian and protection needs.
With 1.9 million people who were newly displaced in 2017, DR Congo is the African country with the highest number of displaced persons. On the health front, 2017 recorded the worst cholera epidemic of the past 15 years with over 55,000 cases and more than 1,000 deaths; over 42,000 measles were also recorded in 2017.
“The past year has been one of the most difficult for millions of civilians, with the unrelenting cycle of violence, diseases, malnutrition and loss of livelihoods taking a toll on families. Today’s appeal reflects the magnitude, severity and unpredictability of a crisis that has gone on for far too long. We are grappling with one of the world’s largest, most acute, and complex humanitarian crisis”, Humanitarian Coordinator Kim Bolduc today said in Kinshasa.
This bleak outlook is taking place as funding for humanitarian action in the DRC is particularly low. Only half of the $812.5 million appealed for in 2017 was received. While the Kasai crisis continues to require great attention, North Kivu is the single most affected province most affected by population movement and related needs.
For 2018, the updated plan estimates that boys and girls below 18 years old make up 60 percent of those in need. Close to 50 percent of the funding would go towards emergency health and life-saving food security projects. “Without the essential support of the humanitarian community, the survival of thousands of people is at risk, and hopes of early recovery will be dashed. We must ensure sufficient funding so to match the magnitude of the crisis”, Bolduc today said.
17 Jan 2018
Humanitarian situation in DR Congo reaches breaking point as funding gap remains enormous reports International Organization for Migration
The humanitarian situation in the Democratic Republic of the Congo (DRC) has deteriorated dramatically over the past year due to a massive escalation of conflict and widespread insecurity. Extreme violence has spread to areas typically considered stable, such as the provinces of Kasai and Tanganyika. The situation has been recently compounded by deadly floods and an outbreak of Cholera, among multiple other health emergencies, while the IOM, the UN Migration Agency humanitarian appeal, released at the end of last year, remains vastly underfunded.
Some 4.3 million people are displaced throughout the DRC; 1.7 million of whom were violently forced to flee their homes in 2017. This recent spike of displacement has made the DRC the country with the highest number of internally displaced people in Africa. The majority of newly displaced people say that food is their biggest need and, in some areas, many of them have yet to receive any humanitarian assistance due to lack of funding.
In total, 13.1 million people will be in need of humanitarian assistance throughout the country in 2018. Children, young men, women and ethnic minorities have been among the hardest-hit. More than 4 million children under the age of five are at risk of acute malnutrition. Some 7.7 million people are expected to be impacted by the devastating effects of an acute food emergency, while 10.5 million have limited or no access to healthcare. An estimated 4.7 million women and girls will be exposed to gender-based violence (GBV) in crisis-affected areas in 2018.
“The humanitarian situation in the DRC is at breaking point as is our capacity to respond due to extremely limited funding,” said Jean-Philippe Chauzy, IOM DRC Chief of Mission. IOM is coordinating humanitarian activities in three of these provinces experiencing the highest levels of displacement: Kasai, North Kivu, and Tanganyika. “The stories that Congolese, who have been forced from their homes, are telling us are bone-chilling. They have been through so much already – torture, rape and murder of their loved ones – we cannot stand idly by as they suffer in silence.”
16 Jan 2018
Central African Republic: Violence fuels “Neglected Humanitarian Tragedy,” with half of the Population in Need of Aid, report the International Committee of the Red Cross.
The International Committee of the Red Cross (ICRC) warns that humanitarian conditions in the Central African Republic (CAR) are rapidly deteriorating, with half of the population in need of humanitarian aid.
One in five people from the CAR have been forced from their homes by escalating violence, the highest level of displacement since the crisis erupted in 2013. Currently the north-west and south-east of the country are worst hit.
"The Central African Republic is one of the most neglected humanitarian tragedies in our world today. This week I have met people who had to flee for their lives—often sleeping in the bush for weeks and months with barely any shelter, food, or clean water," said ICRC President Peter Maurer from the capital Bangui.
"The humanitarian needs are enormous and yet the crisis remains largely underfunded, leaving the ICRC and other organizations overstretched to ensure those affected have access to life-saving services."
People not only need shelter, food, safe drinking water and household items, but they also must feel safe in such an insecure environment where sexual violence is rampant.
CAR has the highest number of reported incidents against humanitarian and health workers in the world, greatly affecting the delivery of essential services. Last year alone, 13 Red Cross workers were killed in the line of duty.
"It is crucial that what is happening in CAR is not forgotten or ignored. I urgently call for far greater attention and engagement from the international community for those who are suffering the impact of the violence here," said Mr Maurer. "Beyond an increase in humanitarian aid, we need organizations with influence to help create the conditions for a lasting improvement in people''s lives."
Jan. 2018
U.N. forced to cut food aid for refugees in east Africa due to lack of funds. (WFP)
Cuts in food rations for 1.5 million refugees in east Africa, due to funding shortages, could increase school dropouts, crime and malnutrition, a United Nations official said this week.
With humanitarian needs rising around the world, donors are prioritising crises in Syria, Yemen and Bangladesh, said Peter Smerdon, the World Food Programme (WFP)''s east Africa spokesman.
As a result, refugees in Kenya, Ethiopia, Tanzania and Rwanda fleeing drought and conflict have had maize, beans and vegetable oil rations cut by almost a third over the last seven months, he said.
"In my 15 years at WFP, I have never seen this number of refugees, at this time of year, having cuts to their food rations," he said.
"Needs have gone through the roof for the whole of the humanitarian system, and donors are claiming they can''t keep up with these increased needs. And the longer they continue, the more likely people will fall through the cracks."
The four east African nations provide sanctuary for millions fleeing drought in the Horn of Africa and protracted conflict in Somalia and South Sudan - the world''s youngest nation - where civil war has created the continent''s biggest refugee crisis.
WFP has only received about one-fifth of almost $360 million required to support refugees in Ethiopia, Kenya, Rwanda and Tanzania in 2018, Smerdon said.
He warned that WFP would have to further reduce rations if funding did not come through. "Child malnutrition will certainly go up."

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