September 2000 at EHP

What’s New?

Increasing cases of Japanese encephalitis, especially among the poor of the Terai region, is becoming a significant health and economic burden to Nepal.  EHP, which conducted a cross-border workshop on vector-borne diseases, provides technical support on epidemiology, serology and laboratory diagnosis.

Cross-Border Workshop on Vector-Borne Diseases Held in Nepal

More than 50 experts on vector-borne disease surveillance and control from Bangladesh, Bhutan, India, and Nepal, as well as representatives from selected organizations, participated in a workshop at the Vector-borne Disease Research and Training Center (VBDRTC), Hetauda, Nepal, from July 25 to 28, 2000.

EHP’s program staff based in Kathmandu conducted the workshop. (EHP is implementing a program, jointly sponsored by USAID/Nepal and HMG Nepal’s Ministry of Health, entitled Prevention and Control of Selected Infectious Diseases in Nepal.)

The workshop consisted of three plenary sessions and two working group sessions. In the plenary sessions, experts from each country as well as organizational representatives gave an overview of the technical and operational aspects of vector-borne disease (VBD) control in their area. Speakers from all countries expressed the need for collaborative action and institutional links and networks as vital in combating VBDs.

The workshop closed with a consensus on five follow-up activities to be implemented and coordinated with the support of EHP/Nepal:

(1) Establish VBDRTC/Nepal as a nodal institution to coordinate inter-country cross-border issues on malaria, kala-azar, and Japanese encephalitis. A Bangladesh, Bhutan, India, and Nepal (BBIN) network and website will also be set up shortly by EHP, with subsequent management by the VBDRTC.

(2) Conduct a workshop to standardize cross-border VBD surveillance approaches. The goals of the workshop will be:

• To establish consensus on the operational definition of cross-border surveillance and
• To provide a forum to produce a detailed surveillance reporting format.

(3) Conduct inter-country training to standardize the laboratory diagnosis of Japanese encephalitis. The potential venue for the training is the National Institute of Virology, Pune, India.

(4) Conduct a workshop on development of behavior change messages, based on findings from a study of community-based approaches in kala-azar prevention in Bihar State, India, and Dhanusha District, Nepal. The tentative venue for the workshop is the VBDRTC, Hetauda, Nepal.

(5) Update cross-border information on vector insecticide susceptibility and drug resistance. VBD program managers from each of the four participating countries–Bangladesh, Bhutan, India, and Nepal–will be responsible for this activity.

Workshop participants predicted that these activities would contribute significantly to the overall prevention and control efforts of malaria, kala-azar, and Japanese encephalitis in South Asia.

Work Starts Up for the Water and Sanitation Rehabilitation Program in Nicaragua

Five PVOs operating in Nicaragua have begun the implementation phase of the Emergency Rural Water Supply, Sanitation, and Environmental Health Program.  EHP is coordinating and facilitating the overall program.  The program, funded by the USAID Mission to Nicaragua, will be carried out in close coordination with both ENACAL (the water and sanitation agency of the government) and MINSA (the health agency of the government).  The purpose of the program (which is described in January 2000, February 2000, and April 2000 at EHP) is to increase water supply services for up to 100,000 people in the departments and municipalities of Nicaragua most adversely affected by Hurricane Mitch in October 1998.

This month’s update report provides brief descriptions of two of the five PVOs that were awarded grants: ADRA Nicaragua and Action Against Hunger. Together, the five organizations, working with full participation of the communities involved, will bring physical improvements in water and sanitation and will undertake environmental education and hygiene behavior programs for beneficiaries in six departments of Nicaragua. (In the July update of the web site, we will present profiles of the other three grantees: Save the Children Nicaragua, Alistar, and Plan International.)

Adventist Development and Relief Agency (ADRA Nicaragua)

Summary of Activities: ADRA signed a country agreement with the Nicaraguan government in 1990, following the lengthy civil war. ADRA’s work in Nicaragua began with a food-for-work project as well as child survival interventions in the former war zone. Throughout the 1990s, ADRA continued to implement child survival programs and food distribution programs. 

After Hurricane Mitch, ADRA’s work expanded to include water, sanitation, housing, child survival, and food-for-work projects in 15 municipalities. It is currently involved in such diverse activities as health education in the poorest communities in the former war zone; housing construction for those left homeless following the hurricane; and food-for-work programs which reach 7,600 families via agricultural/infrastructure, water and sanitation, and child survival programs. ADRA is also in a partnership with eight other NGOs to strengthen health services for the population. In the area of water and sanitation, ADRA is currently implementing a project under the aegis of DANIDA.  In that activity, new wells and latrines are being built for more than 60 public schools in northern Nicaragua.

Plans under the EHP Grant Program: Under EHP’s grant program, ADRA was awarded a grant of $1.5 million. The 17-month program began in April 2000. ADRA will concentrate its efforts on reconstruction of wells, latrines, and gravity water systems in the Las Segovias region of Northern Nicaragua. This former war zone and Hurricane Mitch-affected area is considered one of the poorest regions in the country; over 57% of the population have no proper latrine facility, and only 24% have access to potable water using methodologies that encourage community participation. ADRA will construct 1,340 latrines, 45 wells, and 11 gravity-flow water systems.

Contact information: Mr. Anthony Stahl, Executive Director: Email: [email protected]

 Action Against Hunger

Mission: Action Against Hunger works worldwide in 40 countries.  Over 350 overseas and 4,000 local workers carry out AAH programs.  It is currently running 

about 80 relief and rehabilitation programs with a five-pronged approach to eradicating hunger: food security, nutrition, water, health, and disaster preparedness. Action Against Hunger has treated 3.5 million victims of hunger and malnutrition. Its aim is to save lives, then begin rebuilding and developing long-term sustainable systems through training and monitoring. AAH’s program help restore self-sufficiency and dignity to the lives of its beneficiaries.

Summary of Activities: AAH programs in Nicaragua facilitate the provision of and access to safe drinking water through digging wells, protecting springs, and improving gravity-flow systems. AAH also implements sanitation programs such as building latrines, showers, and wastewater evacuation systems.  The populations served are involved in all aspects of the project including project design and training programs for maintenance to protect the long-term viability of construction and rehabilitation programs.  Health education is a key element of AAH’s project interventions and is designed to address the health aspects of potable water, latrines and personal hygiene.

Plans under the EHP Grant Program: AAH received a grant to implement water and sanitation programs for the dispersed rural populations of seven municipalities in the Department of Madriz, one in the Department of Nueva Segovia, and one in the Department of Esteli. The goal is to improve the health and sanitary conditions of rural communities affected heavily by Hurricane Mitch. Specifically, AAH will construct 3 new water points and 4 new gravity-flow systems, and it will rehabilitate 14 water points and 4 gravity-flow systems. AAH is also to build 600 latrines. The grant also includes a hygiene education component, i.e., promotion of behaviors to protect clean water, to care for and maintain the new water points, and to maintain hygiene and sanitation practices which will prevent cholera. Training will be provided for beneficiaries and local technicians. The project is anticipated to benefit 9,000 people.

Contact information: Nicolás Berlanga, National Coordinator: Email: [email protected]