January Behind the News

Indonesia Health Screening

Health Education begins with a children’s health screening in Tanah Keke, an island of Sulawesi, Indonesia.

News provided by Global Hope Network International



One change that has been brought about by decades of conflict in Afghanistan is the declining numbers of Nomads.  There were once some four million Nomads who roamed with their herds between warmer lowlands in winter and mountain pastures in summer.  This very mobility became a source of vulnerability as the country became divided up between warlords supported by local commanders.  This vulnerability occurred because the Nomads could not claim protection from any one commander.  A former Nomad said “Commanders in each area did not care about night or day; they sent soldiers to seize our sheep or cows.”

There are today only one million or so herders who are fully nomadic.  Others have settled in towns or petitioned the government for land so that they could pursue settled agriculture. GHNI is doing Transformational Community Development in a number of settlements of these Nomads with local villagers.



Pastoralism as a way of life is under threat from environmental degradation, land-grabbing and re-settlement throughout East Africa.  But in arid regions of southern Ethiopia, it remains a viable, even lucrative, source of livelihood.  A picture gallery in The Guardian newspaper reveals how community organization in Borena district helps to maintain the water sources on which the herds depend, regulate access to the water points, and preserve grazing areas for emergency use in times of drought.  GHNI has now been working in the Borena district and has helped many families become self-sustainable through agricultural education via our Miracle Acre demonstration plots. Read more…



Almost two thirds of Indonesian men and one third of adult women smoke, making Indonesia third in the world for the number of smokers.  Yet a new law requiring health warnings to be included in cigarette packaging has been passed, despite intense opposition by tobacco farmers and cigarette manufacturers.  Manufacturers have been given eighteen months to comply with the law.

Community-based health initiatives by GHNI staff in Sulawesi are helping many of the poorest of the poor learn the benefits of health education.



Tsetse flies which transmit sleeping sickness to humans and the equivalent disease in cattle (nagana) apparently dislike the smell of waterbuck.  Scientists at ICIPE, the International Centre for Insect Physiology and Ecology, have used this information to isolate the chemical constituents of this disagreeable odor.  They found a way to infuse the odor into a collar to be worn by cattle.  Trials of the collar at Shimba Hills nearMombasaare going well.  The benefits are not only limited to higher survival rates among cattle, but because the animals are sick less often, their rejuvenated power can be used to cultivate the soil for crops such as cassava, maize and sweet potatoes. Our agricultural projects amongst the Borana outside Isiolo Kenya have produced a bumper crop of onions through our teaching amongst these pastoral people.



When the 17-year ceasefire between the government and the Kachin Independence Army broke down in 2011, there were two consequences for the health sector.  The number of people in need, not only for the treatment of physical trauma, but for mental health problems provoked by fear and anxiety, increased hugely.  At the same time, the capacity of the health system to respond deteriorated because of the transfer of health workers away from the conflict areas and also because of the increasing shortage of medicines.  Many people displaced by the conflict were accommodated in government-controlled camps where poor sanitation and poor nutrition continue to undermine the health of the inhabitants. GHNI is presently scheduled to teach Transformational Community Development for several dozen volunteers working amongst the poorest of the poor.



A report in The Guardian newspaper (4 January 2013) on the water and sanitation sector (WASH) in Nepal argues that much of the expenditure in the sector is misdirected and inefficient.  The result is that there has been no material impact on the rate of childhood diarrhea.

In 2009, a major cholera epidemic affected 70,000 people across 27 districts and left 380 people dead.  Among the causes of the poor outcomes are the fragmentation of responsibility across three government ministries.  Donors provide one third of funding for the sector completely uncoordinated with government efforts.  There is a focus on water supply rather than sanitation and a lack of attention to hygienic practices so that 20% of the toilets which do exist are dirty and under-used.  The toilets also suffer from neglect of maintenance.  Whereas according to policy stipulations, 20% of the budget should be applied to maintenance, in practice it is less than 1%.  Around 80% of water supply schemes need repair, rehabilitation or reconstruction. GHNI is taking the approach of Health Prevention through education at the village level.  Community-based efforts like these translate into effective water usage, etc.



Nigeriais one of only three countries (the others are Afghanistanand Pakistan) still endemic for polio.  Intensified efforts are being applied to these last outposts of a devastating and killer disease as part of the Global Eradication Initiative.  These efforts include the payment of incentives to staff to participate in outreach campaigns.  But this very intensity has had unforeseen adverse consequences.  One problem is that so many primary care health workers are drawn into the outreach campaign activities for which incentives are paid that there are sometimes too few workers at the static health centers to perform routine vaccinations.  GHNI uses mostly volunteers from within their own villages to support these schemes so that any corruption is almost impossible. Read more…



Deaths in Syria from bullets, rockets, and bombs are widely reported.  But there are other victims of an under-reported by-product of the on-going conflict:  the deterioration of the healthcare system.  Those hospitals still functioning have become over-crowded and are running out of supplies, especially of items that need to be imported.  Suppliers and shippers are reluctant to handle orders fromSyriafor fear of violating sanctions.

Meanwhile, domestic industry which used to provide 90% of the country’s pharmaceutical needs is down to one third of its former level of production. As a result, drug prices have risen, and are often unaffordable, particularly for those needing long-term medication for chronic conditions.  Many doctors have emigrated, for example half of those formerly working in the city of Homs.  Of the health workers that remain, many struggle to get to work due to snipers and government roadblocks.  A UN appeal for humanitarian assistance included more than $53 million for health in 2012, of which less than a third was raised.

GLOBAL HOPE NETWORK INTERNATIONAL is presently helping Syrian refugees in Lebanon and Jordan and is making plans to use model villages as teaching centers for Community-Based Health education. Read more…

Section Two: Feature Article of the Month

Education: Ethiopia


Mention Ethiopia and the image that immediately comes to mind is of children with stick-like legs and protuberant bellies caught on a television newscast during one of the recurrent famines in the Horn of Africa. Ethiopiahas long been known as one of the poorest countries inAfrica, with one of the highest rates of population growth.  It is all the more remarkable then to be able to report significant progress towards two of the Millennium Development Goals, those concerned with education enrollment and gender equity.

This report is based on a study by Jakob Engel published by the British-based Overseas Development Institute.  Perhaps the most striking finding of the original paper was “in 1992, almost four out of five children were out of school.  Fifteen years later, this figure had dropped to approximately one in five.”  Such a massive increase in the school system in such a relatively short time would be impressive in any circumstances, but given the poverty of the country, the expansion in the number of school-aged children, the ethnic and geographic diversity, and the devastation of infrastructure in the preceding civil war, the achievement is quite astounding.  Moreover, the expansion of the school system has been accompanied by distributional shifts in favor of female enrollment, rural areas and pastoral peoples.

In raw numbers, children in primary schooling increased from 3 million in 1994-95 to 15.5 million in 2008-09.  Numbers in secondary education are much smaller, and the rate of growth slightly lower.  Nevertheless, from under half a million in 1996-97, children in the first cycle of secondary education approximately tripled by 2008-09.  An analysis of enrollment by grade level and school ownership shows that the huge growth in the system was largely driven by government expansion of primary schooling.  As the total numbers have expanded, the proportion of over-age pupils has fallen, though it remains high. The gender gap in access to primary education has closed; the gender parity index was 0.66 in 1991 and it had increased to 0.88 in 2007.

The government policies which have facilitated these dramatically increased enrollments include a huge investment in school building and the training and hiring of additional teachers and education administrators.  External donors were induced to support the strategy; in some years they provided more than half the funding for the education sector, although control of policies remained firmly in government hands.  School fees were abolished and in some cases school feeding schemes were introduced, which reduced the incentive for parents to keep children at home to benefit from their labor.    Decisions concerning schooling were increasingly devolved to more local levels of the administrative system and the former insistence on Amharic as the medium of instruction was abandoned in favor of mother-tongue instruction.

Over and above the direct benefits of additional schooling, there have been associated social changes.  One is the reduction in the frequency of child marriages as more girls continue their education to higher levels.  This has also served beneficial in a reduction in the fertility rate and reduced exposure to the perils to both mother and baby of precocious childbearing.  The well-known association between female education, lower fertility and improved child-rearing practice is being realized in Ethiopia.

One of the conspicuous successes of Ethiopia has been in mobilizing voluntary community contributions in support of the public education system in two main forms.  One is participation in governance, with parents taking their place in School Management Committees and Parent Teacher Associations, which have been particularly concerned with enrollments and absenteeism.  The other is financial contributions, especially for capital expenditures, which also prompt voluntary labor contributions.  Both stem from a radical change in the outlook of parents who themselves had very limited access to education, encapsulated in this quotation: “As for me, I want to contribute because I have seen my children reading and writing, and I want more.  I am very poor but whenever they ask for contribution, I will do everything to get that money.”

There is inevitably some downside to such an explosive growth of the education system.  One concern is a decline in quality, manifest in falling performance as measured by student scores, and the opinion of focus groups of parents, teachers and students, assembled as part of the National Learning Assessment.  It emerged that the pupil-teacher ratio had deteriorated sharply, from 33:1 in 1994-95 to 66:1 in 2004-05.  It subsequently improved slightly, to 54:1 in 2008-09.  It also appeared that the percentage of qualified teachers had been broadly stable throughout the period.  Another concern is that despite the efforts to reduce inequities in the system, there were still major differences between the regions of Ethiopia, with the two pastoral regions (Afar and Somali) still far below the national average levels of enrollment.  It is still the case that enrollment is much lower among the poorest segment of the population.

These persisting problems are blemishes, but they should not obscure the achievements of Ethiopia in expanding access to educational opportunity and allowing millions of chronically poor children to attend school for the first time.

GHNI includes primary education of all children as an integral part of our TCD efforts. We are so happy to announce that soon in Hurso, a forsaken village in Somalia, there will now be a school program for all its children.  The village worked with us to build the school and now an NGO specializing in education will be providing the program!

Help us as we help villages to change their world!

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