Jan 1, 2021

The Transformative Impact of Caregiver Engagement

Jasem with Concern staff. Photo: Concern Worldwide
Jasem with Concern staff. Photo: Concern Worldwide

When Syrian refugee and father of five Jasem* arrived in Turkey in 2017, life was difficult. He and his young family of six, with his eldest who was nine years of age, were sharing a house with their extended family. It took him a full year to find a job and the support needed as they settled. In those early days as refugees, Jasem admits that he was not coping well with life’s forced changes.

“I wasn’t treating my wife and children well—I was hitting my children due to my own financial and psychological situation.”

Jasem became a daily worker, sometimes working in agriculture or in the local market, taking whatever irregular job was offered to him. His two oldest girls worked with their father and therefore did not attend school regularly. Staff in the local Concern community center became aware of the family’s challenges and began to work with them on a program that offers cash in exchange for children’s participation in education and psychosocial support.

Central to Concern’s holistic approach to meet the psychosocial needs of vulnerable refugee families is the Caregiver Engagement approach. It empowers parents and guardians to provide a positive learning environment at home for their children and helps them support their children’s wellbeing and development. The 10-week program provides a platform for caregivers to discuss the challenges and the achievements of raising their children.

In the Caregiver Engagement program, participants discuss a wide variety of topics, participate in role plays, watch videos and engage in interactive group work. Concern facilitators, who live and work in the same neighborhoods as the participants, provide a safe space for participants to share experiences, ask questions, try out new strategies, and explore new ideas. These sessions are open to all refugees and are offered around participants’ schedules, including evening and weekend hours. Depending on what is most convenient for participants, sessions are offered in the community centers or in their homes. Due to the current COVID-19 pandemic, sessions are facilitated remotely via WhatsApp.  

Jasem initially got involved with the program after his eldest daughter asked him to participate. Although he was reluctant to attend at the start, Jasem enjoyed the group discussions where participants shared their opinions and experiences.

“The facilitators respected us, treated us with dignity, and dealt with us as equals. They had humility. We felt that we were one family who exchanged ideas and advice with each other.” 

After participating in many CGE sessions, Jasem found new and positive ways to express himself and manage his anger. 

“I used to spend my time out playing cards with my friends—matters of no importance. Now I spend all my time at home with my children. I know how to take care of my children and my wife. All of this had an impact on their education level, which started to improve.”

The most important Caregiver Engagement sessions for Jasem were those about adolescents, their wellbeing and development. He learned about adolescents’ personalities, how to deal with teenagers, how parents can build trust and empathy with their teenage children and how to exercise self-control. 

“I learned how to manage my anger. I was ignorant of the concept of positive parenting. Now, my hope for my family is that we live happily ever after. I want us to be able to adapt to any challenges that arise.”

*Names changed for safety and security reasons.

Jasem participates in Caregiver Engagement/Concern
Jasem participates in Caregiver Engagement/Concern
Oct 30, 2020

Three Years into the Rohingya Refugee Crisis

Photo: Abir Abdullah/ Concern Worldwide
Photo: Abir Abdullah/ Concern Worldwide

It’s been three years since the Rohingya people fled violence and persecution in Rakhine State in Myanmar. Nearly a million refugees now reside in Cox’s Bazar in Bangladesh, forming the world’s largest refugee camp. Without an end in sight to this situation, here are 5 things to know about the Rohingya crisis as it currently stands at the end of 2020.

1. THIS ISN’T AN ISOLATED CRISIS FOR THE ROHINGYA

The Rohingya are a predominantly minority ethnic group, many of whom have lived in Myanmar’s Rakhine State for generations. Without recognition as citizens or permanent residents of the country, the Rohingya have long had limited access to education, jobs, and health services, resulting in chronic poverty and marginalization. Violence targeting the Rohingya in Myanmar over the last several decades has driven hundreds of thousands to neighboring countries, most notably in 1978, 1991-92, and 2016. An escalation in violence in 2017 became the starting point for the latest — and largest — crisis. 

2. THE CURRENT CRISIS HAS BECOME MORE COMPLEX — ESPECIALLY WITH COVID-19

The mass exodus of Rohingya refugees into neighboring Bangladesh has developed into a protracted emergency for both refugees and host communities. Most of the camps were built on uneven sandy hills that were rapidly cleared to make way for refugees and services. Over the last three years, these informal settlements have faced the constant threats of flooding, landslides, and shelter collapse.

The main cyclone season begins in April, and previous years have shown us that this the in which the Rohingya are most vulnerable. Beyond shelters facing destruction from high winds, these rainy seasons can also foster waterborne illnesses in crowded camps that don’t have proper water and sanitation facilities — posing a particular risk to children and the elderly.

Then, the COVID-19 pandemic reached the camps in the summer of 2020. Quarantines and lockdowns in Bangladesh have made it harder for essential supplies, including food and medical items, to make it into the camps.

3. OVER 100 ORGANIZATIONS ARE RESPONDING TO THE ROHINGYA CRISIS

Concern is one the many non-governmental organizations — both local and international — responding to the influx of Rohingya refugees in Bangladesh. Because we have been in Bangladesh for over 40 years, with both former staff and experience in the Cox’s Bazar area, we were one of the first organizations to respond to the crisis there. 

Since then, we’ve maintained a combination of life-saving integrated nutrition support, livelihood development, disaster risk reduction, non-food item distributions, and home gardening initiatives. Our goal, along with many of our partners and humanitarian colleagues, is to help the Rohingya stay healthy, care for their families, and live with as much security and dignity as possible.

4. THE ROHINGYA CRISIS IS ALSO A BANGLADESHI CRISIS

Often underreported in coverage of any refugee crisis is the host community’s efforts to maintain their own welfare. The area surrounding Cox’s Bazar is a very poor area of Bangladesh with a history of weak service provision. Concern’s Country Director in Bangladesh, A.K.M. Musha, points out that local lives have changed significantly since this massive population flow. 

“There is huge socio-economic and environmental pressure resulting in increased tension between refugees and the host community,” he says. “The tensions will continue to increase unless the host communities are supported well. It’s a difficult situation for all.”

While the Bangladeshi government has gone to great lengths to accommodate the influx, the impact is being felt as local resources go into the relief effort, prices of goods and services rise, and labor becomes cheaper.

5. THERE’S NO END IN SIGHT

“The Rohingya people don’t believe the situation in Myanmar is currently conducive to repatriation. It would be very difficult for people to go back to Myanmar unless the situation improves there,” adds Musha.

Despite all this, Concern’s Emergency Director in Bangladesh, Heather Macey says thatthemood among the Rohingya communityis one of resilience and defiance.

“They are people before they are refugees. You have doctors and musicians and artists living in these camps. You can’t forget that. The people have gone through and survivedso much,”she explained.

“They are the drivers of their own change…The people are not hopeless.”

Thank you for your support of Concern’s work with both refugees and their host communities to realize this change for a brighter future, together.

Oct 13, 2020

Our Greatest Tool to Fight Malnutrition

A child being fed RUTF by her mother (South Sudan)
A child being fed RUTF by her mother (South Sudan)

This year marks the 20th anniversary of a hallmark Concern Worldwide program, one that has revolutionized the fight against hunger around the world: Community-Based Management of Acute Malnutrition (CMAM).

With hunger on the rise in East Africa and beyond due to COVID-19, we wanted to take this opportunity to give our generous supporters an in-depth look into the development of what continues to be our key method for facing the hunger challenge head-on.

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During the hunger emergencies of the 1980s and 1990s, children with severe acute malnutrition required around-the-clock care at therapeutic feeding centers (TFCs). The nutrients were delivered through therapeutic milk, which required on-site preparation and clean water. Because of the need for 24-hour medical staffing, TFCs were few and far between. Mothers would often need to leave their homes for weeks at a time, which meant lost work and other children left behind. 

Recovery rates were low because moms would often withdraw their children before they received full treatment to return to work. Infection was also a risk in the crowded patient wards. Millions of children unnecessarily died because they were too far away, relapsed after an incomplete course of treatment, or were exposed to other illnesses.

Community-based care seemed to be the solution, but there was one more problem: At the time, there wasn’t a suitable therapeutic food that could be used at home by mothers. Everything required water and if the family used contaminated water, they risked further harming their child. 

RUTF (ready-to-use therapeutic food) gives malnourished children the vital nutrients they need to recover. The original and most well-known RUTF, Plumpy’nut, is a peanut-based paste served in a foil pouch. This means that it’s portable, non-perishable, and can be eaten by babies who aren’t yet ready for solid foods.

The exact ingredients for an RUTF can vary based on the brand, but the standard RUTF has the same features: high in calories, nutrients, and vitamins to help children suffering from acute malnutrition rapidly gain weight. 

In 2000, famine swept through the Horn of Africa, threatening millions of people in Ethiopia. The government had banned TFCs as they believed them to be ineffective. This gave Concern an opportunity to pilot its new CMAM program model with Plumpy’nut. 

Community members were trained to recognize the signs of malnutrition using tools like MUAC tape (which uses the measurement of a child’s arm as a correlation for malnutrition). They were also trained in how to administer Plumpy’nut at home. Children were then monitored through home visits by these trained health workers. 

Together, CMAM and RUTF proved to be a powerful duo. In emergencies such as famines, the child mortality rate can often climb to 20 to 30%. With the combined use of CMAM and RUTF in Ethiopia, mortality rates were 4.5%.

In 2007, the World Health Organization, UNICEF, and the World Food Programme issued a joint statement recognizing community-based therapeutic care as a best practice, setting in motion a global spread for this transformative approach.

With just small packets of peanut paste, Concern Worldwide and other humanitarian organizations have successfully treated millions of acutely malnourished children and continue to do so today. 

In a time when travel and interpersonal contact must be limited for public health and safety, the CMAM model has become even more indispensable. When COVID began, Concern created a guide for health and nutrition staff to adjust the program to continue treating children experiencing extreme hunger during lockdowns and with minimal risk of viral transmission.

Thank you for your support of our efforts, including CMAM, to combat hunger in East Africa. Concern could not innovate, adapt, and grow without the generous help of people like you!

 
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