Girls in northern Kenya, where the food problem is immediate, are provided with DFID-funded food aid. Credit: Amanda Rose

With the 25^th Anniversary of the release of the Band Aid record coming up, there is increasing public attention on the situation in the Horn of Africa; and rightly so, with over twenty million people across the region facing the need for humanitarian assistance.  I think that the media coverage of Ethiopia has got it about right so far; they are not showing images of starving children, because there is no famine at the moment. Instead they are focusing on the impending risks of an emergency coming early next year, and emphasising the need for the Ethiopian Government and aid agencies to agree quickly on the scale of the problem and get the assistance in position early. In Kenya and Somalia though, the problem is immediate, and media images show the struggles of Somali refugees in Dabaab camp who have fled the fighting as well as the impact of the drought.

Band Aids and Beyond - click for the report

Ensuring that people survive a drought is right, but it is not enough. The recent Oxfam report Band Aids and Beyond points to the importance of Disaster Risk Management where action is taken to build people’s resilience to threats to their lives and livelihoods.  Action for the long term is needed, as well as emergency help. As this report acknowledges, this is exactly what DFID is doing. 

DFID is helping improve agriculture in Ethiopia. Credit: Toby Sexton

So far this year DFID has provided over £100 million to Ethiopia to deliver major improvements in the country’s health, education and agriculture services, as well as funding the Productive Safety Nets Programme which helps 7 million very poor people to lift themselves out of poverty by building a sustainable livelihood. 

Net-making cash-for-work in Turkana, Kenya. Credit: Thomas Omondi

The same approach is taken in Kenya where DFID supports cash-for-work and food-for-assets programmes for people in the drought hit northern areas, as well as longer term development work.

British MPs have also been expressing concern. Gareth Thomas, the Minister of State for International Development had to answer questions from MPs in the House of Commons on 21^st October about the situation in East Africa. You can see in this clip how much of the attention was concentrated on what the UK aid programme is doing to help in the long term.

Nearly twenty five years ago on that hot day in Holland Park my fundraising event may have flopped. But Ethiopia and other countries in the region have come a long way since then. Populations have doubled in that time, but proportionately the number at risk has been falling, as Ethiopia has put early warning systems in place, pre-positioned food stocks, and helped make peoples’ livelihoods more resistant to shocks.

The situation is bad. Over twenty million people in Ethiopia, Kenya and Somalia in need of humanitarian assistance, much of it food aid, over the next few months. And it could get even worse early next year, depending on how the current harvest pans out. That’s why Douglas Alexander, the Secretary of State for International Development, last week announced last week a further £39 million of humanitarian support for countries in the Horn. 

Mohammed shows his failed crops

This time last year I visited the Somali region of Ethiopia when it was already getting bad for the farmers. I met Mohammed from near Jigiga who knelt down in his field and showed me the state of his crops. This was meant to be a sorghum field, but it was just dust; the only thing growing was a toxic weed, dangerous for both humans and cattle. His first sorghum sowing had withered away when the rains had failed. Looking over his bare fields, he was expecting a gloomy harvest for himself and fellow villagers. The rains have been worse in 2009 over much of the region, and in Somalia the ongoing conflict has displaced millions.

What’s the reason for the food shortages; why are things so bad again for so many people? There are, of course, a host of reasons alongside the poor rains. Reaching those people most in need in the conflict areas is tough and dangerous; food prices, particularly in Kenya, have stayed high; governments and agencies have not been quick enough to act.  But one of the underlying causes for these problems is undoubtedly climate change. 

Food security in the Horn of Africa (Credit: IPC / FEWS NET, Sept 2009) - click for bigger picture

Climate change prediction models are not yet accurate enough to say what will happen where with any great clarity, but we do expect the dry areas of East Africa to get drier. With this will come food and water shortages, population shifts and economic losses. Perhaps this is what we are already seeing. The security implications of these changes are complex and not well understood, because different societies cope differently with changes, but we do know that even if climate change may not be a direct cause of conflict, it does create conditions that make it more likely and more severe. The Stern Review emphasised that environmental degradation will lead to competition for natural resources, scarcity, migration and potentially destabilisation and conflict.  

1816 was the year without summer. Mount Tambora on the Indonesian island of Sumbawa, blew its top and threw a massive amount of volcanic dust into the atmosphere in one the largest volcanic explosions of modern times. In his article ‘A brief history of climate change and conflict’ James Lee explains that ‘the volcanic dust travelled worldwide, blocking the sun’s rays and lowering temperatures.  The period of extreme cold, coupled with the eruption, produced a ‘year without summer’’. The season’s crops were lost and the cold forced people in Europe to migrate. But as the land across the continent was relatively densely settled, conflict came with the population movement. The result was social upheaval, riots and disease.

Back to Mohammed and the Greenpeace leafleters. The insecurity in much of the Horn of Africa and the stress that many people are suffering may not be a direct result of climate change, but the connections are too strong to ignore. The message in the Greenpeace leaflets about getting real results at the Copenhagen Climate Change Conference will be vital for Mohammed and his fellow farmers.

This blog features as part of Blog Action Day and the Act on Copenhagen campaign

Elizabeth Carriere

This will be my last blog post from Rwanda. My appointment in Kigali was just for six months, so now I’m going back to Britain to lead our Africa Conflict and Humanitarian Unit, and I plan to continue to blog based out of London. The great news is that Elizabeth Carriere has arrived as the new Head of DFID Rwanda and Burundi.  She has been promising to everyone that she will definitely stay three years in Kigali, so there will be good continuity of leadership. Elizabeth comes direct from heading up DFID’s work in the Caribbean, and has lots of experience in Asian countries.

And Elizabeth had some great news about Rwanda to trumpet in her first week. The country has made an extraordinary leap in the World Bank’s ‘Doing Business’ ranking, rising 76 places from 143^rd position to 67^th this year. That’s the biggest jump in the ranking that has ever been achieved by any country in a single year, and makes Rwanda the top global performer among 183 countries. DFID can claim a part in this success, having supported business environment reforms for the past two years. There are loads of opportunities for Elizabeth and the DFID team to make a real difference in Rwanda.

Just before leaving I thought I would check out who has been reading this blog. So I asked Simon, my techno-wiz friend at DFID, to get out the clicker; he worked out that the posts have been viewed about 4500 times, with people viewing from over 60 different countries. Has it been worth it? Well, it is hardly in the Stephen Fry Twitter league, but it has been good to get all sorts of responses ranging from Rwandan nationals concerned about youth issues, to a Genocide researcher from LSE in the UK wanting to discuss his research findings, to an official from the British TUC interested in the new labour laws.

Guhonda the mountain gorilla

It’s been a great place to live. My family came out for a few weeks’ holiday, and we got to see Rwanda’s one totally unique tourist sight – the oldest Silverback in the Volcanoes National Park, called Guhonda. He is one of only 786 mountain gorillas left in the world. He has been generating tourist revenues for the country for over 29 years, even during Dian Fossey’s time. I thought I’d sign off my time in Rwanda with his photo.

No, it isn’t always like that, and in the last few years there has been a shift towards a more equal partnership, with a real desire growing to make aid have even more impact. On the 4th September last year donors and Partner Countries signed up to the Accra Agenda for Action to improve aid effectiveness, and that’s had real impact here in Rwanda. This year it felt like the tables were turned on the donors.

Click for the UK's 2008 Rwanda aid effectiveness scores

At the Development Partners meeting a few months back, all donors were held to account by the Ministry of Finance for the promises they had made, using a list of 18 commitments we had all signed up to – such as delivering the money we had pledged, recording our aid in the Government budget, and giving clear indications of our future financial plans. Every donor’s score was put up on the screen for everyone to see, and there were some red faces round the room - the lowest score was 2/18. The UK was near the top, I’m pleased to say, but we still need to improve, as we only scored 12/18.

So at the end of last month, when Douglas Alexander agreed to £107 million of budget support for Rwanda, I wrote a short article in the local English language paper explaining why and how Britain gives aid, emphasising our desire for a relationship which helps create sustainable development, and making our work really effective, impacting on the lives of poor Rwandans. 

Signing the Agreement for the Land Programme with the Rwandan Minister of Finance. Credit: New Times

And that is important to me. I am only in Rwanda for six months and finish here soon. But I am lucky enough to have been able to get some great work going that will benefit the Rwandan people, such as our new support to roll out the land tenure programme all across the country: a programme which has got lots of international press coverage. How will it work? Following the approach of the Accra Agenda, we are combining with several other donors in a 'basket fund' where we pool our money - so only one set of reports and accounts is needed, making life easier for the Rwanda Land Tenure Centre.  We are also sticking to the Accra principles by working jointly with the World Bank and the Land Tenure Centre to monitor the programme's impact - ensuring every landowner in Rwanda can receive land title to their plot.

Have you heard of the Golden Rule?  'He who owns the Gold, makes the Rules'.  I reckon the Golden Rule is now well and truly broken in Rwanda.

A quiet Saturday in Kigali

This was Umuganda, where every citizen is expected to work freely for the community, on the last Saturday of the month, and politicians lead the way by example.  In Kigali all the shops and markets close, buses and taxis stop, and the place falls silent.  It seems a world away from the UK: can you imagine Oxford Street closing down on a Saturday? Or the weekly footy game being called off?

Click for more Umuganda photos on Flickr

While the impact of Umuganda volunteers is limited to their local area, it certainly brings people together in a useful piece of work. Unfortunately I didn’t get any photos this time round, but a search on Flickr brings up 40 Umuganda-related photos if you want to see the impact it has.

There are also over 100 British political activists and MPs in Rwanda on a 2 week volunteering Project Umubano. We squashed them into DFID’s conference room for their briefing, and it was the first (and probably last) time that it has been standing room only for British MPs listening to me on the difference British aid makes in Rwanda – 400,000 more children in schools, a fair tax system that is bringing in the cash to move Rwanda to self sufficiency, and 15% growth in food production last year. The Project gives participants an experience of rural or urban life, and allows them to contribute their skills as teachers, doctors or business people -and they pay for it all themselves.

I think volunteering is great; I spent three months in rural west Kenya when I left college, and then I went on as a VSO in the Pacific.  Although what I contributed to the local community on Mount Elgon as a short term volunteer was minimal (building a house, a bit of agriculture), the experience changed my outlook.  I was shocked by the malnourished children, by the destabilising impact of local political and military insecurity; I was going to become a Chartered Surveyor, but my experience made me determined to work in development in the future.  That was 29 years ago -  and I am still involved. 

DFID supports Platform2 which has sent volunteers to Ghana, South Africa and other countries and is implemented by Christian Aid, Islamic Relief and BUNAC. It is designed for young people from less advantaged backgrounds (read some of the testimonials of participants here - they are brilliant!), but there are lots of other good schemes around as well; - not only for young people but increasingly for mature experienced people with top skills to share.  But I always say be careful; only volunteer if you are prepared to let it change your life.

Genocide poster

The first was by Jack Straw, Minister of Justice.  He said that the UK is going to change the law on genocide, war crimes and crimes against humanity, to ensure that people accused of these crimes since 1991 can be prosecuted in the British courts.  This is to rectify the situation where suspected genocide criminals from the 1994 Rwandan genocide have not been tried because their crimes took place before 2001. This will put right what many Rwandans feel has been a loophole in British justice.

The second was the launch by Douglas Alexander, DFID's Secretary of State of a new UK policy paper on international development.  You can get all the details here, but I want to highlight a few things that we will be following up hard in DFID Rwanda.  He makes the important point that we need to keep pursuing the Millennium Development Goals - so, it's still a big ‘yes' to health, education and clean water.  But the world - and Rwanda - has been changing since the MDGs were established over 10 years ago, and now we recognise even more the importance of climate change, conflict, and economic growth, which underpin all the efforts to get basic services to the poorest people.

My team here are trying to make this a reality.  On climate change we're working with the Rwandan Government to take a leading position in Africa's negotiations running up to the Climate Change conference in Copenhagen in November this year.  On conflict we have a project with the Mines Awareness Trust to finally clear the country of all land mines left over from the war of the early 1990s.  And on growth, we are going to give substantial support for Rwanda's entry into the East African Community, boosting trade, jobs and incomes.

I expect the woman in the red cap may never have known what ‘DFID' meant.  But now we have a new logo that she can recognise: ‘UKaid': it's clear and simple, and I believe it does what it says on the tin.

A newborn is nursed in an incubator

The nurse gently turned the over the little baby in the incubator, checking his condition; she indicated that he was doing well. In the Intensive Care Unit in Kibagabaga District Hospital, Dr Blaize showed us the equipment they have for premature and sick babies. It looked good, clean and new – just like the hospital buildings which were put up in 2006.

At the hospital reception area Dr Blaize borrowed a woman’s yellow mutuelle de sante insurance card to show me what it looked like; she misunderstood what he was doing and protested, thinking that the card was being confiscated. Apologising, he returned the card – but it showed me the value that this woman gave to her membership of her healthcare insurance scheme. She had paid 1000 Rwandan Francs (about £1.25) for the year, after which she only needed to pay a flat rate co-payment of RWF250 for each visit.

Just down the road, I was taken to Kimironko Health Centre. Like the Hospital, it is situated in a moderately well off part of Kigali city, so the facilities were in good condition, staff were available to see patients, and the payment system was well organised. According to the mutuelle organiser there are 65,500 people living in the two areas covered by the insurance scheme; of these 35,000 were members, and a further 10,000 had their membership paid for by local non-Government organisations or by the Government ‘Farge’ scheme which assists children of the genocide. There are other insurance schemes in Rwanda, for the military, for formal sector workers, and private membership schemes, and these cover many of the other people who came – though 5 out of the 100 patients who had come to the health centre that day had no insurance and had to find the full cost of the consultation, tests and drugs.

I want to add a few more thoughts to my last post on paying for healthcare in Rwanda because Rob Yates’ comment made me want to go and find out a bit more of the reality on the ground. The World Health Organization is advocating for free antenatal health care, as an essential way of reducing maternal deaths and ensuring that young babies survive. So I have visited two health centres and a District Hospital around Kigali in the last few days, and I was surprised by the different arrangements that exist for health funding.

An AIDS awareness poster in Kigali city

The Cor Unum Health Centre in Kimisagara sector is in a high density housing area, with many very poor people as their clients. The centre is supported by Caritas, which runs over 100 health centres in Rwanda, but the Government also provides funding for 10 staff, and the Elizabeth Glazer Pediatric AIDS Foundations support significant aids work, including staff and drugs. It’s a busy centre with at least 200 patients coming per day. The average HIV infection rate is 9.8% for all people tested, but 18% for women aged 25-45, which is significantly higher than the national average of 3%. According to the nurses they have a good supply of AIDS drugs because AIDS medication is well funded in the country, but other drugs are often short.

The mutuelle system works successfully here too.  Membership fees are RWF1000 per year, with flat rate co-payments of RWF200 for each visit. At Cor Unum, antenatal care costs a flat rate of 1000 Rwandan Francs for visits and treatments. For most people, except the poorest, this is a great insurance system. But there are two big questions:

Firstly, can the mutuelle system support the demand for health care? In this centre it looks difficult as they are owed substantial sums of money by the mutuelle organisation, which puts a severe strain on Cor Unum’s ability to operate properly.

And secondly what about antenatal care? This is the critical time – pregnancy and little children under 5 when most deaths occur. If these payments can be completely covered for the poorest, many lives would be saved.

Baby Swallows

OK, let's back to the Swallows - I've got to write about them first, as several people reading this blog have asked me how they are getting on.  Four weeks ago, the three baby swallows in the nest on my balcony fledged.   ie they came out of the nest and flew - up onto the guttering, and then, after four days of shouting at their parents to feed them - they were gone.  Just like human children, I expect; their departure left me feeling at little empty. 

To add to that, I have been away from Kigali for a couple of weeks in the UK where a close relative passed away, which was very sad for me and my family.  Most of us from the UK don't encounter death regularly; children are inoculated at birth against all sorts of diseases, everyone gets plenty of good food, and the health service is well equipped and can fix many problems.  But things aren't the same in Rwanda.  This morning I cycled past King Faisal Hospital - which is the main hospital in town, with the best facilities and some of the country's top medical specialists.  But even with this available, some of the richest people in the country will still travel to Nairobi or South Africa if they have serious health problems.

Drugs in a health centre pharmacy

That route is only available to very few, of course; everyone else uses what is available locally.  In the rural areas (ie most of the country) there are small health centres with inpatient beds and outpatient clinics, staffed by nurses and sometimes a doctor, who can treat minor conditions.  The health centre pharmacy should be stocked with the standard range of basic drugs, including ARVs.  But still the current health numbers for Rwanda are shocking to me: 103 out of every thousand children die before their fifth birthday - that is one in every ten little kids you see on the street die before they are 5 years old (it is 6.5 per 1000 in the UK), and 750 women out of every 100,000 giving birth will die as a result of their pregnancy (that is one woman dying in childbirth every three hours ). 

The big problem is resources: the Rwandan Government does not have enough money to go round all the needs: to put it in perspective, the British Government last had the same amount of money per head available as Rwanda has now to spend on its population, in 1709 - exactly 300 years ago.  So choices are really tough, and the way the Government deals with it in the health sector is having a mutual contributory health insurance scheme, known as the ‘Mutuelles de Sante'.  Membership costs £1.30 per person per year, and the poorest should get their contributions paid.  About 70% of the population are members, and attendance at health centres has hugely increased as a result.  

Laurent Rugero

But because people have to make a co-payment of £0.20 for each visit and pay 10% of the cost of hospital treatment, some people still do not come, fearing bills which they have no way of paying. Take Lauent Rugero, the blind, disabled, ex-soldier I met in Kayonza; there is no way he could afford these payments; he only has a bed, some clothers and a few cooking implements in his 10 foot square mud built house. But other, richer people can afford them - and could make even larger contributions.  Some argue that a completely free system would be best, but the Government fears unnecessary use of the system and creating a culture of dependency, so financial contributions continue. 

Controversial stuff, certainly, (see this document, Towards universal health coverage in Rwanda, a 2007 briefing by Caroline Kayonga, Permanent Secretary, Ministry of Health, Rwanda) but vital to get it right.  DFID is a major contributor to the health system, but in the long run it will be Rwandan people and their Government who will shoulder the full burden of paying the costs of health, and they need a system that will fit their circumstances.

The swallows were successful in bringing up their offspring - I don't think any died; luckier than many families living here.  Now they have even come back to the nest to have another brood, and I won't be able to resist writing about their future progress.

Living south of the Equator has some definite advantages: one is that I get to see the Southern Cross star pattern at night time: it is a great constellation telling you exactly where south is. But what is interesting is that I can actually see the Southern Cross from here in the centre of Kigali. In much of the UK, where I come from, it is hard to see the stars because of light pollution, but that’s not the problem here.  Only 6% of households have power in their homes, and most of these are in the major towns, so rural people rely on firewood, charcoal and kerosene as their main fuel.

Carrying wood for the fire - click for bigger picture

Yesterday I met these two women from the village of Rwesero about 35 km north of Kigali; they were virtually buried under their loads of wood which they had gathered for cooking. The head-load will last for a few days to cook a pot of beans and potatoes and heat water for tea. But it is hard work collecting the sticks and a long way to walk. There is electricity in Rwesero, but only a very few houses have connections, and they will only use it for lighting as electricity is much too expensive to cook with.

Most of Rwanda’s power is currently produced by big diesel generators, but this is very costly and relies on being able to truck up fuel from the East African coast, a thousand miles away. Recent news is that the methane under Lake Kivu is starting to be used to produce electricity, and there are plans to hugely increase the hydro electric plants on the Rusizi River between Rwanda, the Congo and Burundi.

Hydro power is a terrific clean energy source with virtually no carbon impacts, but the big risk with climate change is that rainfall will be reduced and there won’t be sufficient water in the rivers to generate power. 

Maresa and Liberal

And this is where Liberal Seburikoko and Maresa Oosterman come in. Liberal and Maresa are DFID Rwanda’s climate change leaders. They have been helping the Government of Rwanda organise a meeting in Kigali this week for African Finance Ministers to learn about the effects of climate change and the financial opportunities available for adaptation or mitigation. So this conference, and the lead-up to the world Climate Change convention in Copenhagen, are really crucial for Rwanda and other small nations.

While I love seeing the Southern Cross from my balcony, if losing that sight means that the women from Rwesero have got power, it is a loss well worth taking.

Fishermen mending their nets

Over the Labour Day break I took a trip to Akagera National Park on the Eastern border of Rwanda, next to Tanzania. It is a large open expanse of savanna and woodland dotted with beautiful lakes. The wildlife is limited and rather hard to spot, but I did find some interesting examples of people trying to make livelihoods right on the edge of the Park.

Fisherman were netting tilapia from their canoes and selling them on to traders at ridiculously low prices. It certainly tasted great straight off their fire at the lakeside, but, as they say, you don't make money from producing food, only from trading it.

Ankole cattle

Then there were herdsmen driving their Ankole cattle - a traditional, but declining species in East Africa, which are famous for their huge horns. Ankole cattle are rarely eaten in Rwanda, but all the websites say that their meat has the lowest cholesterol count in the world - there must be a business opportunity in this for someone.

Although Kigali city has all the essential paraphernalia of a modern African city - glass fronted office blocks, good coffee shops and traffic jams - Rwanda is essentially a very rural country. About 80% of all Rwandans depend on agriculture for their living (in the UK it is less than 3%).  Most farmers have very small plots of land and grow maize, beans and vegetables; some keep cows or goats which are kept in a pen and fed grass cut from the roadside. In the higher lands, they grow coffee and tea. So the country's economy is very dependant on the performance of agriculture; if there are good rains, like in 2008, the harvest is large and generally everyone gains. Of course, when the rains are poor, many people suffer.

While it is important for Rwanda to diversify and develop other sources of wealth and employment, agriculture is still critical for the majority of poor people. In DFID we have decided to concentrate on supporting two areas to help farmers: land title registration and access to finance. Having title to your land means you can invest in it with confidence, and you also have security to get a loan from a bank. But the banking system is still limited in Rwanda, so we are now developing a programme to help banks and finance institutions reach poor people more easily. 

The above three-minute DFID YouTube video titled Rwanda: 15 years on - Land and Security shows how Mary and Rhamadan, two farmers from the north of the country have gained from getting their own title deed to their farm.

The swallows feeding their young

Just to finish off on the livestock theme: if you have read my earlier blog posts such as Dear Ollie, I mentioned the swallows on my balcony.  They built a nest a few weeks ago, and the female had been sitting there quietly, while the male was perched on the handrail. Today I noticed that both parents were off the nest, flying back and forth every couple of minutes, obviously feeding their new babies. I hope they survive.