Springtime brings a season of change at Global Washington. May 31 will be my last day at GlobalWA after a 10-year tenure as I announced back in March. The Global Washington Board of Directors along with GoodCitizen activated a search process for the new Executive Director in February and they will be making a decision within the next few weeks. In the meantime, long-time Global Washington board member Jane Meseck will be stepping in as part-time Interim Executive Director and has already started working with me and other staff to ensure the continuity of the organization.
I’m also thrilled to announce Megan Chao as our new part-time Operations and Membership Coordinator. Megan has over 15 years of experience in global development and certificates in Non-profit Management and Bookkeeping. She is passionate about equity, equipping local leadership, and non-profit collaboration to solve systemic issues. We are excited to have her join our team!
I am so proud of the past accomplishments of Global Washington and I can’t wait to see the future innovations under new leadership. The organization will be in good hands and continue to be the trusted, thriving network for global development in the Pacific Northwest. Feel free to reach out to me via LinkedIn and I wish you all well.
Women waiting for pre- and post-natal care at a Sukarya health clinic, Haryana, India. Photo: Joel Meyers
When we think about global health, we might not specifically think about women’s health, but women spend 25% more time with significant health issues than men. This time adds up to approximately nine years over a lifetime – nine years! The term Disability Adjusted Life Years, or DALYs, represents the loss of one year of full health. This means collectively women have lost 75 million DALYs, or years of full health. That’s astounding. Why is this?
Economically, the benefits of closing this health gap are immense. For every dollar spent, there’s a potential $3+ return in economic growth, which would boost the global economy by more than $1 trillion a year by 2040. GlobalWA partners are doing incredible work to close this gap as part of a growing commitment to change the status quo.
Innovation and Healthcare Systems
To start, in the last several years the Bill & Melinda Gates Foundation established Gender Equality as a major pillar of their work and a program team focused exclusively on women’s health innovations. As part of this effort, Gates leads the Innovation Equity Forum, a group of 250+ experts in research and development (R&D) of women’s health that authored the 2023 Women’s Health Innovation Opportunity Map. Though not a map per se, the document identifies 50 critical opportunities across the R&D ecosystem to catalyze women’s health innovations, from data and modeling to research design and methodology.
According to CARE, approximately 1 in 49 women in poor countries die from preventable causes related to pregnancy, and in Sierra Leone, it’s 1 in 17 women. One of CARE’s 2030 goals is for 30 million more women to be able to access their right to sexual and reproductive health. Their Right to Health strategy aims to build resilient, equitable, and accountable health systems that can deliver the health solutions we already have on this earth to everyone who needs them. In Bihar, India in particular, a project with the Gates Foundation focused on reducing the rates of maternal, newborn, and child mortality and malnutrition, and improving immunization rates and reproductive health services across the state. Their work reduced the maternal mortality rate by almost half in 16 years.
The Kati Collective’s work revolves around developing equity-focused strategies. Malaria No More came to them with the hypothesis that fighting malaria through a gendered lens could improve malaria eradication while also enhancing gender equity. Kati Collective set out to research and test this theory and the effects of malaria on women. Their research showed that women spent significant time caregiving for malaria cases, four times as much as men. Better yet, they found that malaria eradication is one of the most effective levers for reversing poverty for women. In Uganda, for example, the 3.3 million children under 5 treated for malaria annually creates an economic impact of $333 million for their families.
Cancer
For the Fred Hutch Cancer Institute, education and awareness are an important part of reducing disparities in cancer diagnosis and outcomes around the world. Their Breast Cancer Initiative aims to reduce disparities globally for 2.5 million women by 2025 through information and outreach. Similarly, they founded the Breast Health Global Initiative with Susan G. Komen, which is an alliance of health organizations, companies, and providers that develops affordable and culturally appropriate guidelines for breast health and treatment in low- and middle-income countries. In a partnership with the Uganda Cancer Institute, the UCI-Fred Hutch Cancer Centre in Kampala serves the larger region and sees 20,000 patients each year.
Last year, the Max Foundation launched the Max Access Solutions program to treat advanced breast cancer in nine Countries across Africa, Latin America, and South Asia with plans to expand this year. The organization’s mission is to accelerate health equity by delivering medication, technology, and services to cancer patients who are not otherwise able to get the care they need. Why breast cancer? It’s the leading cause of death for women globally as 80% of patients in developing countries are diagnosed at the metastatic stage and have poor access to treatment when they are finally diagnosed. Max is working with multiple partners to implement the program through its Humanitarian Partnership for Access to Critical Treatment (Humanitarian PACT) for Advanced Breast Cancer.
Community Health
Water and sanitation are also an issue that disproportionately affects women and girls, who typically bear the responsibility of fetching water. The Starbucks Foundation’s goal is to empower 1 million women and girls in coffee-, tea- and cocoa-growing communities by 2030 after they blew past their 2018 goal of 250,000 women in a little over half the time. Notably, their programs promote water, sanitation, and hygiene (WASH) as well as women’s leadership and economic development in 17 countries.
More than twenty years ago, Global Communities established an inpatient facility for women with high-risk pregnancies in Huehuetenango, Guatemala called Casa Materna (Mother’s House). In partnership with a local association of midwives and the Ministry of Health, the center trains community health workers to identify women with high-risk pregnancies and refer them to Casa Materna for care. The program has provided more than 100,000 indigenous Mayan women with culturally sensitive and high-quality reproductive health care and facilitated more than 13,000 safe deliveries.
Sukarya believes that society cannot progress without healthy women and children. Their Rural Community Health Action program tackles this issue from the lens of anemia and malnutrition in Haryana and Rajasthan, India. Covering 60 villages in the region, it focuses on strengthening detection, treatment, and prevention of anemia and malnutrition, as well as delivering immunizations and WASH components.
The Hunger Project looks at health from a holistic lens, through hunger, nutrition, water, and sanitation, and more. But the key to their approach is starting with women as they are typically the primary bearers of responsibility for the health and nutrition of a family, yet often lack the resources, knowledge, and freedom to fulfill this responsibility to the best of their abilities.
Emergency Situations
During an emergency like a natural disaster or war, breastfeeding might be the last thing on some people’s minds. But for World Vision, one of their primary focus areas is preventing malnutrition for infants, children, pregnant women, and breastfeeding mothers.
World Vision partners with ministries of health to establish safe spaces to breastfeed and find counseling, health and nutrition education, and breastfeeding support. Take Srijana who was seven-months pregnant when an earthquake hit Nepal in 2015, barely getting out of her house before it collapsed. World Vision not only helped her maintain her nutrition during pregnancy but gave her a space to safely breastfeed her “survivor” baby and develop the skills they needed to set themselves out on the right path.
Like World Vision, Americares also works to protect pregnant women in emergency situations. In Ukraine, they provide emergency obstetric kits for mothers forced to give birth outside of traditional health care settings. And in Colombia, thousands of expecting mothers have been traveling from the humanitarian crisis in Venezuela to seek basic health care at Americares clinics.
While these are just a selection of GlobalWA organizations at the forefront of the fight on women’s global health, they demonstrate the growing sea change in global health, shifting the focus to a world of health equity. Recognizing and addressing the unique health needs of women (who have a proclivity to depression and anxiety over men) is essential for achieving sustainable development goals and ensuring social and economic progress. Addressing women’s health issues can have a ripple effect, positively impacting future generations and creating healthier, more equitable societies where all individuals can thrive.
The following additional GlobalWA members are providing quality healthcare services and support through their programs in low- and middle-income countries where they work.
We envision a world where every person has access to quality health and education services, no matter where they live. We bring this to life by delivering leading programmes across Maternal, Newborn and Child Health, and Remote Community Development.
Kati Collective is a global consulting collaborative focused on understanding, analyzing, and advancing health and gender equity as an essential means of achieving global development goals. We believe in data-driven approaches and that many perspectives, both local and global, must come together for impactful and equitable systemic change.
Kati offers tailored approaches for strategy development, evaluation, process management, design, facilitation, management of communities of practice, and co-creation with local organizations.
Panorama Global is a platform for social change. We partner with changemakers to create an equitable and sustainable world where all people thrive. Our initiatives span global health equity, climate change and sexual and reproductive health and rights (SRHR), adolescent mental health, and gender equity, among others. Learn more about Panorama’s work.
The Type 1 Diabetes Community Fund aims to unlock resources for historically underfunded community-based organizations (CBOs) in low- and middle-income countries while uplifting their work and unveiling insights into the challenges of existing health systems and barriers faced by people living with type 1 diabetes. Learn more about our grantee partners.
Climate change is the greatest global health threat of the 21st century, with severe implications for women and girls’ sexual and reproductive health and rights (SRHR). Panorama is leading an initiative to bridge the gap in understanding the impacts of climate change on SRHR, an issue area frequently overlooked by researchers, policymakers, and funders. This work includes grantmaking to support community advocacy in the Global South, facilitating a funder Community of Practice, and building an evidence base in partnership with YLabs to advance climate-resilient women’s health and SRHR solutions.
PPGNHAIK draws upon its expertise as a leading provider of sexual and reproductive health services and comprehensive sexuality education to deliver capacity building support to partner organizations in low- and middle-income countries. Through these partnerships, PPGNHAIK’s Global Programs department supports efforts to improve sexual and reproductive health outcomes for young people.
Save the Children believes every child deserves a future. In the US and globally in more than 100 countries, the organization gives children a healthy start in life, the opportunity to learn, and protection from harm. Save the Children does whatever it takes for children, every day and in times of crisis, transforming their lives and the future we share.
SIGN Fracture Care supports surgeons in low- and middle-income countries (LMIC) by providing orthopaedic education opportunities and donating instruments and implants appropriate for use in austere settings that are designed and manufactured at our Richland, WA headquarters. This enables local surgeons to provide affordable and effective care for patients with long bone fractures.
The gold standard of long bone fracture care is to secure an intramedullary nail in the canal of the bone to stabilize the fracture. By making this treatment available in LMIC, SIGN Fracture Care enables people to quickly recover from fractures and return to health and full mobility. These patients avoid permanent disability and return to work, thus reducing the level of poverty in their community.
Thanks to support from our donors, we provide orthopaedic implants at no cost to hospitals or patients, which makes surgery to repair fractures accessible to impoverished patients. We partner with 431 hospitals in 57 countries and have helped more than 433,000 people recover from fractures over the past 25 years.
Spreeha empowers lives in Bangladesh through compassionate and sustainable solutions to its toughest challenges. At the forefront of this mission is SNEHO, meaning “affectionate” in English, Spreeha’s flagship health program. SNEHO seeks to bolster the nation’s health system by establishing a network of 100 community-led urgent health centers strategically positioned in underserved areas.
Each center, led by trained local health professionals like paramedics, nurses, or medical technologists, offers comprehensive services. These include doctor consultations, sample collection, pharmacies, first aid, and vaccination facilities. Additionally, the program extends its reach to home-bound patients through telemedicine and home visits. Ensuring affordability, services and products are provided at highly discounted rates, with patients receiving e-health records for informed decision-making.
Spreeha’s vision extends to achieving universal health coverage by leveraging technology-enabled hyper-local urgent health centers. By doing so, it aims to alleviate the strain on the overall health system while ensuring quality, accessibility, and affordability for all. Through SNEHO and similar initiatives, Spreeha is actively reshaping the healthcare landscape in Bangladesh for the better.
The Hunger Project facilitates individual and collective action to transform the systems of inequity that create hunger and cause it to persist. We work with rural communities in Africa, Latin America and South Asia, local governments and other health-focused civil society organizations to ensure access to healthcare services and education. In many of the countries where we work, the government is mandated to provide health services. In these cases, our teams work with communities to strengthen their health system through community-led advocacy and accountability. We create platforms for government health workers to leverage and expand their reach. Additionally, through our programs, we equip local volunteer leaders with information, training and materials to go out and educate their communities on key health topics, including nutrition, HIV/AIDS and malaria prevention and treatment, immunizations and maternal and childhood health. We believe that access to adequate healthcare is key to creating a world without hunger.
The most pressing global health challenge is the inequities in access to healthcare. Together, we can alleviate unnecessary suffering and premature death. We must be focused and committed to overcome barriers and ensure universal access for all. Healthcare should not be a privilege – it’s a fundamental human right.
At VillageReach, we are driven by a vision of a world where each person has the health care needed to thrive. We work with governments, the private sector, partners and communities to build responsive primary health care systems that deliver health products and services to the most under-reached.
Responsive systems ensure that health care services are available when and where they are needed, can adapt to changes in demand, and better absorb shocks and stresses, and routinely factor and respond to the needs and preferences of communities.
At VillageReach, we champion responsive primary health care (PHC) and focus our execution in those areas where our technical expertise is the strongest—supply chain innovations that get medicines, vaccines and equipment to people; tech-enabled primary health care that leverages solutions like telehealth that place health information in the palm of a hand; public and private sector engagement including supporting sustained financing of innovation; health information systems that illuminate who is and is not accessing PHC; and collaboration and support of health workers serving under-reached communities.
As a locally driven and globally connected organization working across Africa, VillageReach’s primary goal is to reduce inequities in access to quality primary health care for 350 million people by 2030.
The Yemen Relief and Reconstruction Foundation (YRRF) plays a pivotal role in addressing the dire public health crisis in Yemen. Despite significant funding cuts and the complex political situation, YRRF remains dedicated to alleviating the suffering of Yemeni civilians. In 2023, YRRF implemented various humanitarian projects, including the distribution of food rations to 6,000 families during Ramadan, benefiting 34,000 individuals, and delivering meat to 6,000 families during Eid al-Adha.
Furthermore, YRRF’s efforts focused on supporting malnourished children. The foundation supported multiple malnutrition centers across Yemen, providing critical support to approximately 950 children monthly. YRRF offered immediate nutritional support and extended care for six months post-treatment to prevent relapse. Additionally, YRRF distributed hygienic materials and conducted workshops to educate families on proper feeding practices. YRRF also distributed 750 water filters, ensuring access to clean water.
YRRF also developed a culturally appropriate curriculum to train teachers and school counselors in identifying and addressing PTSD among middle and high school students. Moreover, YRRF launched a vaccination awareness campaign to combat the resurgence of preventable diseases like measles and polio., especially with the spread of dis- and misinformation about vaccines.
YRRF’s comprehensive approach to public health in Yemen demonstrates a steadfast commitment to improving the well-being of vulnerable populations amidst ongoing conflict and economic hardship.
By Joel Meyers, Director of Communications, GlobalWA
Providence doctor mentoring KUHeS medical student at Mangochi District Hospital. Photo courtesy of Kamuzu University of Health Sciences
You may know Providence as a US-based healthcare provider, especially if you live in the western half of the continent. In fact, they have 120,000 caregivers serving in 51 hospitals and over 1,000 clinics, senior services, supportive housing, and many other health and educational services.
Providence’s Global and Domestic Engagement department has supported healthcare practitioners around the globe since 2012 with training, mentoring, and infrastructure improvement initiatives through key partnerships.
These initiatives embody the Providence vision of “health for a better world” by responding to root causes of disparities and working through local partnerships to redress some of the health inequities created by colonization and systemic racism.
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I was first introduced to Providence Global Programs (the “Global” half of Global and Domestic Engagements) through Fast Pitch at our 2023 Goalmakers Conference. Fast Pitch is a segment of the conference where select members stand on stage in front of the conference audience and for two minutes introduce their organization – a fun event that showcases our members’ programs and broadens understanding. You can view a recording of Fast Pitch 2023 here (Providence Global Programs starts at 11:30).
Through Fast Pitch we learned Providence is making an impact through partnership in communities around the world and I wanted to know more and help share this wonderful program with our readers. I was able to connect with Carrie Schonwald, the Director of Providence Global Programs and through the interview we talked about the values that drive this program, the impact it is having, and the partnerships that have provided opportunities for Providence to live into its mission globally.
Guiding Principles
Providence Global Programs is both guided by and is a proud signatory of the Brocher Declaration, which states: “Rather than coming from a mindset of helping and giving, the Brocher Declaration shifts the paradigm of short-term experiences in global health to that of learning and sharing. Relationships between host countries and visitors should be mutually beneficial, with local voices and expertise of host country professionals driving the agenda for health care work.”
Carrie elaborated. She said, by signing and embracing the Declaration, “this was really to say, let’s say this loud and proud. We are about moving the needle on health equity, and equity means being community led. It means supporting the initiatives of a local partner and feeling honored by that and learning and being a learner in that rather than thinking that just because we’re American and we have money that we know more important things. There’s so very much that we don’t know.”
This approach builds bi-directional learning into all the engagements Global Programs supports. And because it’s built into the DNA of their programs, it more directly serves the local communities who have their own vision for their future.
Malawi – investing in a new generation of physicians through education and infrastructure
Since 2017, Providence Global Programs has worked in partnership with the Kamuzu University of Health Sciences (KUHeS) in Malawi and Family Medicine residency programs across the Providence footprint to facilitate bi-directional learning between Malawian and Providence Family Medicine residents. The primary goal of this bi-directional partnership is to increase the pipeline of high-quality primary care clinicians in Malawi, while providing critical training in resilience and compassionate care to US doctors.
This partnership supports the learning of Malawian trainees at both the medical school and post-graduate level, and strategically focuses on broad-spectrum family medicine, which is especially important, since there is such a low physician to patient ratio in lower resource environments. To note, there are currently fewer than 1000 doctors for over 20 million residents of Malawi.
Education
Providence funds a full-time position for a US family medicine doctor to serve as adjunct faculty for the Department of Family Medicine at KUHeS to serve the rural, 500 bed Mangochi District hospital, which is a Family Medicine training site for the department.
“The U.S. doctors are helping to manage,” Carrie explained, “the education of up to 200 clinician trainees per year in family medicine.”
She continues, “We fund US doctors to go there. The US residents go, and they support the learning and mentorship for Malawian family medicine learners. They’re not providing direct patient care. They’re not doing cowboy medicine. They are there as learners and teachers. They learn a tremendous amount from their Malawian colleagues about tropical medicine, about chronic disease management and more than anything about resiliency in a very low resource context.”
Providence also brings several Malawian family medicine medical residents, called registrars, to Seattle for six weeks every fall. These registrars do an observational clinical rotation with the Swedish First Hill Family Medicine Residency, take a University of Washington certificate program on global health leadership, and finally, present at an American Academy of Family Physicians annual conference.
Educational Infrastructure
During Covid, Providence provided five point-of-care ultrasound devices at their partner’s request and funded the training of trainers to utilize them. These devices are an incredible technological development serving across low-resource health systems. Practitioners can carry these handheld rechargeable devices and use them to diagnose a wide spectrum of medical ailments.
Providence also funded the construction of a skills simulation lab in 2021 that will provide simulation training opportunities to about 200 clinical learners a year.
Medical skills simulation lab at Mangochi District Hospital. Photo courtesy of the Dept. of Family Medicine, Kamuzu University of Health Sciences
And, Carrie stated, one of the goals of the program has started being realized, of training practitioners “who would then become the future leaders of healthcare in Malawi. Since 2017 we’ve had 10 Malawian family medicine registrars who have come through our program here, and the dream was always that those trainees would then occupy positions of healthcare leadership in Malawi, and several of them already do so. Two of the doctors from our first cohort are now faculty at KUHeS.”
“We have provided a pretty significant amount of funding to Catholic Relief Services over the last few years to improve water, health, and sanitation facilities at five different clinics across Mangochi district,” Carrie noted. “And that’s been an incredible opportunity to branch into a different aspect of global health and improve the healthcare system for the Mangochi population in a new way.”
Building capacity globally through digital mentorshipwith World Telehealth Initiative
Since 2021, Providence has partnered with World Telehealth Initiative to provide a pipeline of volunteer tele-mentors for clinicians around the world in lower resource settings. World Telehealth Initiative provides a way for global clinicians to connect digitally and build clinical knowledge capacity in settings where continuing medical education and specialist consultations are very limited. Telementoring and helping clinicians using a Teladoc device (a high-resolution live-stream technology) has been very rewarding for dozens of Providence volunteers, especially during Covid. The devices are so high resolution that it really allows mentors to feel like they are in the room where their global colleagues are.
Providence doctor provides tele-consultation to providers in Longisa, Kenya. Photo courtesy of World Telehealth Initiative
Providence volunteers (Carrie informed me they volunteer a minimum of an hour per month) teach and mentor groups of clinicians at one of over twenty global locations where WTI partners. During these sessions, they arrive collaboratively at diagnoses and treatment plans, or “they may provide a specific lesson to a small group of clinicians or teach an entire class with dozens of clinicians. So, it’s very malleable and based on what the needs are at that moment for the local clinician(s) and what the skill set is of the volunteer clinician.”
Telementoring, Carrie explained, is an “incredible antidote to burnout that so many clinicians are experiencing.” And they can do it, literally, from their own living rooms.
WTI – Providence collaboration video.
Global Mentorship Initiative – telementoring non-clinicians
Also known as GMI and a GlobalWA member, Global Mentorship Initiative is another key partnership in Providence’s Global Programs portfolio.
GMI bridges the gap between graduation and first career jobs for underrepresented young professionals from diverse communities. GMI university partners nominate motivated, high potential, underrepresented students as they prepare to graduate and enter the workforce. They then match these students with mentors, in this case from Providence. The mentorship consists of 12 one-hour virtual sessions via videoconferencing and focuses on building confidence and developing soft skills transferable across any industry. Students and mentors set their own schedule. There is no obligation to maintain contact beyond the 12 weeks.
Carrie said that this partnership has been a wonderful way for their non-clinical employees, of which they have “tens and tens of thousands,” to be able to give back.
“It’s an incredibly fulfilling mentorship,” Carrie reflected, “and it’s been really great for us to be able to identify a non-clinical volunteer opportunity, because Covid very much changed the kind of opportunities we have for our employees to be able to volunteer globally. We have been so grateful to have both a clinical and a non-clinical way for our employees to serve communities around the world as this kind of service brings people closer to our mission and renews their sense of purpose in their own work.”
Health for a better world
Service and solidarity beyond borders are essential to Providence’s Mission as a not-for-profit Catholic health system. In its very DNA, the organization’s founding is a result of global outreach from the Sisters of Providence and the Sisters of St. Joseph of Orange who journeyed to the west from Montreal and France. The sisters continue to partner around the world and have always had a vision for Providence to continue partnering with communities beyond our borders.
All of these examples allow Providence to be a leader in creating “health for a better world”, whether it’s from people’s living rooms or boots on the ground.
In her closing remarks, Carrie shared that Providence Global Programs is also part of different global health coalitions both within and outside of Catholic healthcare which allows them to both learn and provide thought leadership, “What is our role in global health and how can we support critical work, or at least educate ourselves and others about that work. We’re always excited to learn about new ways that we can think about global health, and particularly to think about decolonizing and really being self-conscious about our role in global health, and not wanting to perpetuate racist systems or inequitable systems, but rather be a supporter of ongoing change in those systems. That is how we create ‘health for a better world’.”
Behind the Numbers: Rachel Ndirangu’s Personal Journey to Close the Gender Health Gap
By Amber Cortes
A health care worker explains to a patient how to self-inject Sayana Press, the DMPA-SC self-injectable contraceptive, at the Dominique Health Center in Pikine, Senegal. Photo: PATH/Gabe Bienczycki
Rachel Ndirangu knows her numbers.
“Nearly 300,000 women die annually from preventable causes related to pregnancy and childbirth, with 95% in LMICs,” says Rachel, the Africa Regional Director for Advocacy and Public Policy at PATH, an organization that works in countries around the world to advance health equity and close the gender health gap.
For Rachel, these aren’t just statistics—it’s personal.
Rachel was born in the Rift Valley, Kenya “in one of the very lush, green tea plantation areas” where she grew up in a family of four siblings.
At the age of three, she lost her biological mother to eclampsia, a hypertensive disorder of pregnancy that causes seizures, and one of the main direct causes of maternal deaths in Africa.
As Rachel got older, she became curious about the health inequities and health system challenges that contributed to her mother’s death, particularly in her region of Sub-Saharan Africa.
“It gave me a chance to start thinking critically about, you know, why did that happen? Would it have been prevented? And appreciating that it didn’t just happen to me, this happens to hundreds of families daily,” says Rachel.
“And I think this spurred in me the need to work in the global health space. And particularly advocating for equitable access to essential health services for women and girls.”
Rachel Ndirangu, Project Director, Advocacy and Public Policy at PATH
Now a mother of three, Rachel continues to grow her passion to close the health equity gap for women and girls, particularly in her region.
Her role at PATH involves identifying solutions to address policy and financing barriers and accelerate improvement in core primary health care outcomes especially related to Maternal Newborn and Child Health and advancing global health research and development.
Rachel focuses on advocacy and public policy work in Africa. It’s rewarding, she says, to collaborate with diverse partners including policymakers, global health partners, local advocates, and communities to bring health within reach of everyone.
But finding support from public officials and policy makers is not without its challenges.
“Policy influencing is not as easy as just presenting data, or making a human rights argument or an economic argument,” says Rachel.
“Advocacy must be directed to the hearts and minds of these decision makers in order to inspire action.”
For Rachel, this means building relationships through inclusive and continuous dialogue, which takes investments of time and financial resources. Rachel sees every collaboration as an opportunity to build trust, and empower constituents with a sense of ownership and political will.
Using this philosophy, in a long process of addressing policy barriers impacting access to newborn and child health services, Rachel and her team were able to engage policymakers in Kenya around the need to come up with the first ever unified policy for Maternal Newborn and Child Health. This was further reinforced by the adoption of a comprehensive Primary health Care policy framework and Primary Care Networks implementation guidelines that are strengthening the delivery of integrated person center services and products for women, children, and wider communities.
Melanie Impanga Kalenga, a “Mentor Mother,” delivers a health talk to mothers at Kenya General Reference Hospital in Lubumbashi. Mentor mothers are HIV+ women who have successfully given birth to an HIV-negative child and now mentor other HIV+ women who are pregnant. Photo: PATH/Georgina Goodwin
A key highlight of PATH’s policy advocacy in 2023 Uganda is the adoption of the country’s updated and responsive Reproductive, Maternal, Newborn, Child, Adolescent and Aging Health and Nutrition (RMNCAAH+N) strategic Plan, along with an Advocacy Toolkit to help strengthen accountability across all stakeholders. This policy document serves as an important tool for guiding prioritization, planning and resource mobilization for provision of essential health services and technologies as well as tracking of health outcomes for women, girls, and children in Uganda.
“So, it just shows the importance of having actions grounded in strong policies that then rally all actors towards a common action agenda,” says Rachel.
Rachel and her team in PATH have also played a critical role in helping countries understand, adopt, and ratify the African Medicines Agency (AMA) Treaty which aims to improve access to safe and effective medical products in Africa.
There is a need, Rachel says, to meet the challenges of building effective and efficient regulatory process for new products and pharmaceutical innovation that will increase equitable access to populations including women and girls.
According to Rachel, the health needs of women and girls, especially in low and middle-income countries (LMICs), are frequently overlooked, under-researched, and underfunded, leading to chronic underservice by health systems and limited access to comprehensive and affordable care. Regulatory inefficiencies further delay the introduction of essential health products, denying millions of women timely access to lifesaving technologies.
High-income countries dominate the health research and development (R&D) agenda, neglecting the unique needs of women in LMICs, resulting in inadequate products and services. This is exacerbated by insufficient inclusion of women in product design.
There’s also, Rachel says, a tendency to address women’s health in silos, such as a program that focuses exclusively on family planning while another focuses exclusively on HIV prevention for adolescent girls and young women, neglecting to address women’s health needs holistically.
Essential to meeting these challenges is PATH’s concept of self-care (hint: it’s not bath bombs).
“It’s really about enabling women’s access to interventions that place them at the center of their own health decisions,” says Rachel.
One example is the DMPA-SC injectable contraception, a an ‘all-in-one’ self-injectable contraceptive that protects against pregnancy for three months.
Such an intervention, Rachel says, has dual benefits, both to the individual by improving their health literacy, increasing their autonomy, and supporting them to participate directly in their health care, but also to the health system because it leads to more sustainable health systems by optimizing the time spent on patient interaction and reducing the burdens of health care providers.
A health worker with Mildmay Uganda leads a family planning information session for clients, demonstrating the self-injectable contraceptive, subcutaneous DMPA (DMPA-SC). Photo: PATH/Will Boase
This kind of self-care, says Rachel, really has the transformative potential to preserve women’s autonomy, their choice, and even access.
“It’s broken some of the barriers related to, like, I need permission from my husband to go to hospital, or I need to have resources to be able to even just get money or transport to the hospital,” says Rachel.
“So, putting that choice and decision-making power in the hands of women has been quite impactful. In 2023 alone, nearly 1 million DMPA-SC self-injection visits took place across 59 countries that have approved it.”
A community health worker in Uganda demonstrates the self-injectable contraception, subcutaneous DMPA (DMPA-SC). Photo: PATH/Will Boase
Another way to put the power of women’s health in their own hands is being sure women’s voices are included in the R&D process.
In 2023, with support from the Bill and Melinda Gates Foundation, an analysis was conducted by PATH on women’s inclusion in health R&D processes in Kenya and Nigeria, examining policies and assessing the implementation of laws promoting women’s health R&D.
Findings revealed a significant gap between policy and practice: only 25% of clinical trials in these countries exclusively addressed women’s health concerns. Cultural, social, and religious barriers contribute to limited participation in clinical trials and STEM education, resulting in products that inadequately address women’s needs.
The study suggested focusing on policy implementation, establishing funded programs for women’s healthcare careers, providing mentorship opportunities, and collaborating with women-led health advocacy organizations to advance inclusive R&D agendas for women.
Rachel says there’s only one way that global health organizations can focus on meeting the needs of women and girls.
“We need to harness the collective power of innovation, research, and advocacy to create a world where every woman and girl has access to the health care they deserve. But to do that, we need to put women at the center and always remember the investing in women’s health is investing in the global economy!”
Please welcome our newest Global Washington members. Take a moment to familiarize yourself with their work and consider opportunities for support and collaboration!
Burn DesignLab
Burn Design Lab’s mission is to improve lives and protect the environment through the research, design, and development of outstanding cookstoves. Burndesignlab.org
For the past several years, the term “localization” has been held up as the Holy Grail purporting that if the entire global health and development system moves in this direction, all will be solved.
We’re all for being problem solvers, but first, what does localization actually mean? How does an organization implement it? For large, multi-lateral agencies, in particular, the reality of localization is far more complex and far-reaching than many people might expect.
By Roberta Alves, Deputy Director of Communications, Mercy Corps, and Victor Manuel Leiva Linares, Mercy Corps Colombia Communications Manager
Darily Mora, is a Venezuelan migrant who was forced to move to Colombia. Through Mercy Corps and the VenEsperanza consortium, a collaborative effort with IRC, World Vision, and Save the Children, she now has found new hope and resilience. Photo: Mercy Corps Colombia
Venezuelan migration surged by 8.3% between the end of 2023 and 2024, compelling approximately 402,354 individuals to seek refuge beyond their borders, according to data from the NGO coordination platform for humanitarian response in Colombia. Among these migrants, Colombia emerged as the primary destination, hosting nearly 3 million Venezuelan migrants and refugees, as reported by the same NGO platform.
Doctor consultation at urgent health center. Photo: Spreeha Foundation
The Healthcare Maze in Bangladesh
Welcome to the intricate world of healthcare in Bangladesh, where each aspect tells a tale of challenge and strength.
Imagine a country where there are only 7 doctors for every 10,000 people, much lower than what the WHO recommends. Tertiary hospitals strain under the weight of overcrowding and limited resources, where a mere 48 seconds is all a patient gets for consultation on average. You’d have more time to microwave your popcorn than to discuss your health concerns.
Drama group acting in a play called “Better Late than Never” in Malawi. Photo credit: Cosmah Chaula
Imagine a child’s missed vaccination sparking a dramatic scene, not of anger, but of awareness. In Malawi, this is a powerful new approach to public health. Through theatrical performances on local stages, communities are learning about the importance of vaccinations in a way that’s both entertaining and effective.
By Aisha Jumaan, President, Yemen Relief and Reconstruction Foundation (YRRF)
“Polio has no treatment. Best protection is vaccination.”
In the past few years, Yemen experienced a dramatic rise in vaccine-preventable diseases, posing a severe threat to public health amidst an already dire humanitarian crisis. Millions of Yemeni children missed routine immunizations, with only 37% fully vaccinated in 2023. This gap contributed to over 53,000 suspected measles cases and 2,347 confirmed cases. Additionally, there were 1,978 suspected diphtheria cases. The circulation of polio virus type 2 persisted, with three new confirmed cases in 2023, raising the total to 239 confirmed cases since the outbreak began in November 2021. Vaccine disinformation and misinformation further threatened public trust in the vaccination program.
In a momentous step towards revolutionizing healthcare accessibility for secluded island communities in the Oti region of Ghana, the United States Agency for International Development ), in partnership with Global Communities, orchestrated the commissioning and handover ceremony of the groundbreaking “Health Voyager” boat.
Amidst the violence of recent global events, I am finding hope from Global Washington members providing shelter from the storm for refugees. There are over 110 million refugees and displaced people worldwide, the highest number on record since 1951. However, GlobalWA members provide vital programs, credible advocacy, and build awareness of the plight of refugees at different stages of their journey.
The statistics can be overwhelming, but when you read about the effective programs reaching children and families, it brings hope for the future. Here are some programs being provided by GlobalWA members:
Safe Passage for Children: Efforts to support refugee children and families during transit, including providing basic necessities, psychosocial support, and child-friendly spaces.
Shelter and Health: Initiatives to provide healthcare, education, and support services to refugees in camps and host communities, addressing their basic needs and long-term well-being.
Relocation and Resettlement: Programs facilitating the relocation and integration of refugees into new communities, including sponsorship programs and evacuation efforts in crisis situations.
Job Training: Efforts to empower refugees through employment opportunities, vocational training, mentorship programs, and tech-focused job training, aiming to help them rebuild their lives and contribute to their new communities.
Please also listen to my interview with IRC Washington’s Executive Director Kathleen Morris on the GlobalWA podcast here. It is a good reminder that refugees are our neighbors, my kid’s classmates, and part of our thriving communities. It is also important to understand the root causes and why refugees are forced to leave their homes.
Ultimately, our GlobalWA members are helping to create a world where refugees feel welcomed, empowered, and embraced as valuable members of the global community.
Creating a World Where Refugees Feel Welcomed, Empowered, and Embraced
By Cady Susswein
Sudanese mother comforting her child. Photo: Wadi Lissa/Unsplash
There are more than 110 million refugees and displaced people worldwide – the highest number on record since the United Nations’ 1951 Refugee Convention. That’s 110 million individuals, more than a third of which are children, with unique and usually traumatic stories. But that number – roughly the population of Egypt – becomes so easily dehumanizing, too large to imagine. GlobalWA members are doing incredible work to humanize and protect refugees along their journey, assisting them with basic necessities and psychosocial support from the start and eventually helping them create new lives for themselves around the world. These are some of their stories.
Safe Passage with Children
The beginning of a refugee’s journey can be the hardest. Seven-months pregnant with an 18-month-old son, Ana resisted the thought of leaving her home in Ukraine until one day two rockets exploded over her town, and she felt like she had no choice. She left her husband to defend the city and fled to Moldova, where she found herself in a church. The pastor did not refer to her as a refugee, but instead a guest. With support from World Vision, which helps 3.5 million people like Ana every year, she has hope for her future.
While Ana might not have encountered one of UNICEF’s Blue Dot Centers, they assist displaced children and families at dozens of transit routes out Ukraine in a joint effort with Office of the United Nations High Commissioner for Refugees (UNHCR), local authorities, and other partners. Up to 1,000 people use these centers every day in neighboring countries like Moldova, Slovakia, Slovenia, and Belarus to access drinking water and hygiene supplies, health care, psychosocial support, legal information, and more. At each Blue Dot center, there’s a play area where kids can be kids.
Similarly, ChildFund established three child-friendly spaces at Palorinya Refugee Settlement in Uganda, which hosts the largest refugee population in Africa with refugees heavily from the Democratic Republic of Congo and South Sudan. Here children receive basic education and participate in trauma-informed activities designed to facilitate healing. Children can play while their families are working to rebuild their lives. Other ChildFund programs around the world help address the root cause of violence and poverty to prevent refugee scenarios, such as their Protected Passage, which aims to protect children along migratory routes.
Shelter and Health
Since 2017, over 700,000 Rohingya refugees have escaped ethnic and religious conflict in Myanmar and made it to Cox’s Bazar camps in Bangladesh. The Spreeha Foundation runs the health clinic in the camp, providing primary care and maternal and pediatric health services, as well as a team of health educators who train the community on basic health and hygiene issues. The foundation also provides child friendly centers to provide basic education, social and emotional support, and just plain fun.
As thousands of Venezuelans cross the border into Colombia fleeing their country’s economic and humanitarian crisis, Americares works to meet their health needs in 10 health centers and mobile clinics throughout the country, alleviating strain on the local health system. Americares responds to more than 30 crises around the world each year, establishing long-term recovery projects in other conflict areas such as Gaza, Syria, and South Sudan.
Adequate living standards is one of the most basic human rights. In its 13th year of conflict, the shelters that many displaced Syrians live in need critical repairs. Working in the country for the last decade, Global Communities has helped upwards of 480,000 Syrians rehabilitate their accommodations to maintain their privacy and dignity. Also working in response to the crisis in Syria, Concern Worldwide US has rehabilitated 45,000 shelters for Syrian refugees in Lebanon.
Relocation and Resettlement
While there’s a common misconception that refugees are flooding into places like North America and Europe, more than 75% of refugees are hosted by poor, low, and middle-income – usually neighboring – countries. More than half of these refugees are currently from Syria, Afghanistan, and Ukraine with major conflicts in Gaza, Myanmar, and South Sudan to name just a few. But for the small percentage of those that do make their way to the United States, the International Rescue Committee (IRC) has partnered with the U.S. State Department to help everyday Americans sponsor refugees through the Welcome Corps.
Take the Sebatware family for instance. They lived in a refugee camp for 20 years after escaping conflict in the Democratic Republic of the Congo. With the help of IRC, they happily resettled in Phoenix, Arizona, where they were greeted by their Welcome Corps sponsors – a group of least five adult American citizens or permanent residents. To apply, the group submitted a welcome plan, passed background checks, and committed to raising $2,425 for each family member and supporting their integration for at least 90 days while they got their feet on the ground. The Sebatware’s sponsors helped them find housing, jobs, school for the kids, learn English, and apply for necessary documentation in their new life.
In Afghanistan, Operation Snow Leopard has evacuated 1,800 high-risk Afghans since the Taliban retook control of the country in August 2021. Their goal is to evacuate at least 700 more this year with over 4,000 active cases, including women and human rights leaders, children, journalists, and other vulnerable minorities. They work with refugees from evacuation to resettlement. Like Operation Snow Leopard, Jewish Humanitarian Response launched as a reaction to the Taliban takeover as a joint venture between the Aleph Institute and the Raoul Wallenberg Centre for Human Rights. They have evacuated 1,500 Afghans, 500 of which have now made it to their final destination.
Oxfam America helps displaced people not only with immediate needs for clean water, shelter, food, and work, but also advocates for their long-term wellbeing. They engage with governments to find solutions to conflict and advocates for policies and services that refugees need in host countries. Kadidiatou Barry is a mother of four from Burkina Faso. After escaping from the violence of armed groups with only what she could carry, a family hosted hers in the village of Sera, still in Burkina Faso but 70 kilometers away from the violence. With a cash grant from Oxfam and partners, she was able to start a new business, find her own home, and get back on her feet.
Resilience
As part of its their mission to enrich the communities in which they serve, Starbucks has committed itself to employing refugees around the world, hiring more than 5,500 in the last six years. While their original goal was 10,000 in five years, they are working with partners to continue to crack away at the problem, especially in Europe. To do this, Starbucks works with International Rescue Committee (IRC), the Refugee Council in the UK, and other NGOs including Tent, an organization dedicated to matching refugees with corporations, in the U.S, France, and UK.
Working with Starbucks, the IRC assisted Gift Handson, a Zimbabwean native and asylum seeker, with resettlement and transition services to the United States. He participated in IRC’s economic empowerment program called Hospitality Link, which gave him the skills he needed to land a job with Starbucks as a shift supervisor in Silver Spring, MD. He’s hopeful about his future and dreams of one day open a café or an African restaurant. His story is unique but not alone with others like Asma and Tam, who rebuilt their lives with this program.
Last year, Amazon also pledged to hire 5,000 refugees in Europe by 2026, working with the same organization Tent to support immigration and legal fees as well as mentoring and training. Amazon Web Services is also providing IT training to 10,000 Ukrainians around the world.
While refugee organizations and governments offer support, it is usually designed to be short-term. To help close the gap and unlock the potential of young Syrian refugees in Jordan, Mercy Corps reimagined a proven poverty relief model with a human-centered design process to focus on what young refugees really wanted. “Masaruna” is a holistic program that provides tech-focused job training, leveraging digital technology for financial planning and coaching for toxic stress and gender issues that so often plague refugee camps. The hope is that these young Syrians refugees and their families – representing up to 10% of Jordan’s population – can take control of their bright futures. Mercy Corps is working with partner organizations and universities to study the program and expand it.
Global Mentorship Initiative helps underrepresented graduates land their first career-focused jobs through their mentorship pathway. The organization works with universities, nonprofits, and youth partners in more than 90 countries, including eight refugee camps. But while Alnarjes, a young Syrian woman now living in Turkey and pursuing a medical degree, might have directly benefitted from the program, it’s the mentors that often say they learn more from the mentees by putting themselves in another person’s shoes.
While the current refugee crisis presents immense challenges, it also embodies the incredible resilience, strength, and compassion of humanity. Across the globe, individuals, communities, and organizations, like the GlobalWA members mentioned above, are coming together to support and uplift refugees, offering shelter, assistance, and opportunities for a brighter future. Despite facing unimaginable hardships, refugees are not defined by their circumstances but by their unwavering determination to rebuild their lives and contribute to their new communities. GlobalWA members are creating a world where refugees feel welcomed, empowered, and embraced as valuable members of our global community.
In addition to the above-mentioned members, the following GlobalWA members and Pangea grant partners have programs and services in the communities where they work to assist refugees and displaced persons:
ChildFund is a global development organization working to connect children with the people, resources and institutions they need to grow up healthy, educated, skilled and safe. Founded in 1938, we work in 23 countries, reaching about 21.1 million children and family members in 2023, mainly through local partner organizations who lead social change efforts within their communities.
But not all children are able to remain within their communities. Worldwide, there are currently about 50 million children on the move, 14 million of whom are refugees, and many more are experiencing the effects of migration or facing the possibility of it.
ChildFund’s approach to working with Children On the Move, which includes refugees and other children fleeing their homes or at risk of doing so due to violence or disaster, aims to address needs related to both immediate and long-term well-being, including protection and basic services. Our programs offer livelihood opportunities for children and families wishing to stay in their origin communities and others reintegrating into new communities. For those leaving their communities to find safety, we offer psychosocial services, health services and continuity of education along the way.
Global Communities has a rich history of providing emergency aid and protection services to refugees and internally displaced people in many crisis settings, from Ukraine and Gaza to Syria and Guatemala. This includes our Child Protection in Emergencies programming, which supports the well-being of children and addresses risks created or exacerbated by crises, such as abuse and family separation. We build protective environments, strengthen children’s resilience and work to prevent further harm. In Syria, for example, we manage several Child-Friendly Spaces (CFS) for children living in displacement camps. Given the dire conditions in the camps, CFS create safe and welcoming environments where children engage in age-appropriate activities, receive psychosocial services and learn positive coping mechanisms. We also offer parenting sessions and cash assistance, for instance, to ensure that children have stable housing. In Ukraine, we partner with community-based organizations to fill gaps in state services. We engage children in art therapy classes, learn and play activities, and community events to support their healing and recovery. We also foster social cohesion between displaced people and host communities. For example, our recreational activities bring children from the community together with those who have fled the fighting to encourage integration and minimize tensions.
Global Mentorship Initiative is a US-based global nonprofit bridging the gap between graduation and first career jobs for underrepresented young professionals and refugees from diverse communities. Through leveraging digital resources, mentorship, AI, and human connection, we are building a more equitable workforce of tomorrow’s leaders.
GMI’s flagship program is a structured, 12-week, virtual, one-to-one mentorship with a career professional. In four years, GMI has scaled from supporting 20 students to now over 7,000 in 100 countries, including 8 refugee camps.
GMI has supported over 500 refugee learners, many living in camps across Africa and Lebanon. 72% are employed within six months of graduating, in camps where the formal employment rate can be as low as 10%. GMI has partnered with the UNHCR to mentor 1,000 refugee learners over the next two years and support our corporate partners in hiring these bright, motivated candidates. For more information about how you can mentor, sponsor, or hire refugee learners, please contact ravenna.hennane@globalmentorship.org.
The International Rescue Committee responds to the world’s worst humanitarian crises, helping to restore health, safety, education, economic well-being, and power to people devastated by conflict and disaster. Founded in 1933 at the call of Albert Einstein, the IRC works in more than 50 countries.
The IRC has 29 offices across the United States that support newly arrived refugees by providing immediate aid, integration support, and employment services. The IRC is proud to have resettled over 400,000 refugees into the U.S. since World War II. In the United States, we help Afghans, Syrians, Ukrainians, and other refugees as they arrive in their new communities by finding homes, connecting to employment and education, and providing essential items.
When refugees arrive, we welcome them at the airport and connect them to housing. We also donate essential items, including food, clothes, kitchen utensils, and hygiene items. We offer cultural orientation, job training, and English classes while helping newcomers find employment and apply for benefits. We also help enroll children in school, provide immigrant legal assistance, and support finding health care.
At Mercy Corps, we assist refugees through emergency response, providing immediate aid like food, shelter, and hygiene supplies. We offer long-term support by improving access to livelihood opportunities. Through vocational training, refugees work to rebuild their lives and generate income. We also provide essential psychosocial support to help refugees cope with trauma and mental health challenges. We foster social cohesion between refugee and host communities through community engagement activities, promoting understanding and peaceful coexistence. We run campaigns addressing climate-related challenges faced by refugees, advocating for sustainable solutions and resilience-building measures. Additionally, we advocate for refugee rights and needs on a broader scale, engaging with governments and international organizations to shape policies that protect refugees and enhance their access to assistance.
Operation Snow Leopard (OSL) is a US-based nonprofit founded immediately after Kabul’s fall in August 2021. OSL’s primary mission is to safely evacuate and resettle at-risk Afghans, with a strong focus on women and children. We assist vulnerable groups, including women leaders, human rights defenders, lawyers, journalists, interpreters, doctors, activists, and religious minorities. Entirely run by volunteers, including former military personnel, civilians, and Afghans, OSL has conducted dozens of missions, helping nearly 1900 at-risk Afghans evacuate and relocate. OSL raises funds for mission essentials like food, lodging, medical care, travel, and documentation (passports, visas) for Afghans.
Since August 2021, OSL accepted a specific mission to help female Afghan Parliamentarians who were at risk of Taliban retribution. Despite engaging with over forty nations for resettlement pathways over the past two years, OSL was surprised to receive only a few offers. In 2022, OSL partnered with the Inter-Parliamentary Union, participating in international dialogues to aid at-risk Parliamentarians. OSL’s efforts included attending IPU General Assemblies in Bahrain and Geneva and coordinating with the UN. However, despite some progress, government and international institutions have not resolved these high-profile individuals’ resettlement issues. OSL actively renews calls for countries to accept these courageous women and their staff, who bravely risked everything when they stood up for democracy.
Around the world, Oxfam partners with local organizations to help refugees and other displaced people with their immediate basic needs for clean water, shelter, food, and work as well as advocate for their long-term wellbeing—both in their own nations, and in the countries that host them. We engage with allies and government officials at all levels to focus on peace and find sustainable solutions to the conflict and violence that ruin so many lives. We push for wealthy countries to welcome refugees and boldly attend to their needs. And we advocate for public policies that protect the rights of displaced families as they strive to rebuild their lives and fight to provide for their children a more equal future—in their own countries or the ones in which they settle. Read more.
Seattle International Foundation (SIF) believes in just, peaceful and prosperous societies in Central America, and that Central Americans should not be forced to leave their communities in search of refuge and safety. We work to build good governance and equity in order to address key political and social challenges in the region, including authoritarianism, human rights violations, corruption, impunity, violence, gender inequality, and discrimination, as they are push factors for forced displacement and migration.
We invest in organized civil society and independent actors at the forefront of advocacy efforts and to serve as the voice of the public and in independent media whose work increases transparency and accountability of actors in power. We bring together donors and international actors supporting Central America with Central American civil society leaders, including those who have gone into exile for political persecution, so that they can exchange experiences and build strategies to address the main drivers of irregular migration. Above all, we champion the visions of local communities in their efforts to demand political and social change and build the countries they dream of.
Pangea Grant Partners – Refugees
East Africa
Solidarity Eden Foundation, Uganda
2023 funds were used to expand the Women on Wheels program to equip 100 refugee women to gain financial independence: extensive tailing and business training combined with mentoring, mental health support and internships with established tailors. This is a comprehensive program ameliorating the trauma of refugee reality with training and gainful employment.
SE Asia
FORTUNE, Thailand
FORTUNE, a grassroots organization in Fang District in Northern Thailand, is the newest grant partner in Southeast Asia. It was founded in 2009. Its mission is to address the community and human rights needs of Myanmar ethnic migrant workers (many undocumented) who live and work in migrant camps on agricultural farms along the Thai-Myanmar border. FORTUNE provides support to Myanmar refugees and migrant workers living in Thailand.
Empowering Communities: CARE’s Response to the Global Crisis of Internally Displaced People
By Amber Cortes
CARE partner PARC (Palestine Agricultural Relief Committee) distributes 596 hygiene kits to displaced families in two shelters in Rafah, a town on the border with Egypt that used to have around 200,000 inhabitants before October 2023 and now hosts over one million people, crowded in a small space in harrowing conditions. Each hygiene kit covers the needs of a family of five during one month and contains a bath towel, soap, shampoo, laundry powder, toothpaste and toothbrushes, wipes, sanitary pads, and disinfectant. Rafah, southern Gaza, 6 January 2024. Photo: CARE
In her 16 years working with CARE’s Humanitarian Team, Camille Davis has never seen anything so dire as the situation in Gaza.
“And that’s because the situation is really so desperate and horrific,” says Davis, who is now the Senior Director of Humanitarian Resource Mobilization and Planning at CARE, an international humanitarian organization that delivers emergency relief and long-term development projects in 109 countries around the world.
“I mean, we’re six months into this crisis. There is mass displacement, we’re talking about most of the population of Gaza being displaced. And it is a really small area.”
Gaza is one of the most densely populated places in the world, with over 2 million people in an area no bigger than 141 square miles.
Along with the effects of mass displacement, like crowded conditions, low access to safe water and basic sanitation, there is famine due to limited passage of food and other essential needs across borders.
“It’s also a very young population, a lot of children, a lot of young people and children. So, the situation is just heartbreaking. People are already dying from malnutrition…mostly children.”
Despite the challenging operating environment and access issues, CARE is still active in Gaza—doing everything from providing lifesaving medical equipment, safe water, and other relief supplies, to support for maternal health and newborn care, like at their mobile health clinic in Northern Gaza where trained midwives helped deliver 100 babies in the last two months.
CARE partner PARC distributes hygiene kits to displaced families in two shelters in Rafah, southern Gaza, 6 January 2024. Photo: CARE
As one of the oldest relief organizations in the world, CARE has a long history of working in Gaza. Right now, CARE is one of a few organizations with extensive reach throughout the Gaza strip including in the harder to access North where there is active conflict, and Davis credits this in part to the fact that the organization has been working with Palestinian communities since 1948 and has established a network of trusted partners and vendors that they’ve worked with for years.
“To the extent that we’re making progress, it’s entirely because of these relationships and how embedded CARE has been with communities in Gaza for so long,” says Davis.
The situation in Gaza is bringing attention to the plight of internally displaced people, or IDPs, around the world.
An internally displaced person is someone who has been forced to leave their home because of violence, conflict, or natural disasters, and though they are forced to leave their home, their neighborhood, their village, their community, they are unable to leave the country and remain within its borders.
According to the UNHCR, the United Nations Refugee Agency, there are 62.5 million internally displaced people globally, which accounts for 58% of the world’s forcibly displaced population. Since IDPs cannot leave the country, they may not have the same protections as refugees under international law.
This puts many IDPs in the vulnerable position of either trying to leave the country or trying to survive and rebuild there while being trapped within its borders (during whatever conflict or disaster may be occurring).
For example, in Ukraine, CARE has reached nearly 1.3 million people since the crisis started two years ago. About 3.7 million people are displaced within the country’s borders, and hundreds of thousands are returning to the safer areas of Ukraine to try and rebuild their lives.
The ‘Your Support’ shelter in Lviv supported by CARE, hosts around 200 displaced individuals, helping them with nutrition and shelter, and wraparound support services like psychosocial support.
Leona in a shelter in Ivano-Frankivsk, two hours by car from Lviv. The 57-year-ol fled with her daughter from the Donetsk region to Western Ukraine. “The explosions made the whole house shake. My daughter and I slept on the floor in our apartment because we were afraid the windows would break. It was so cold, so we sometimes got up and started jumping up and down,” she says.Now, she manages a shelter in Ivano-Frankivsk. The shelter hosts up to 76 people, but many more are in need for a place to stay. “It is difficult if you have to say no to someone who just arrived at the train station. But we do not have any more beds at the moment,” says Leona. CARE and its partners support shelters for internally displaced people in Ukraine financially and with rehabilitation measures, furniture, and kitchen appliances. Additionally, CARE and its partners help with food, water, hygiene products, and other daily necessities. Hospitals and health facilities are supported with medical equipment and medicine. Photo: CARE
“Your Support” is much more than a shelter, says Davis. It’s about finding strength and hope in being together.
“It’s a place for displaced Ukrainians to celebrate special days together. They cook together they do handicraft workshops and, and just, you know, share stories about their life before the war and what they might be looking forward to.”
CARE is particularly interested in the safety and wellbeing of women and girls, who are at increased at risk of exploitation, sexual abuse, and starvation than their male counterparts in crisis situations.
CARE understands that when it comes to humanitarian assistance, it’s not one size fits all. Their initial emergency assessments include a Rapid Gender Analysis- a flagship tool for understanding the differentiated needs of men, women, girls, and boys in crisis, what risks they face, and what their needs are, so that humanitarian programs can be tailored to address those needs.
They also uphold the principles of Safe Programming to ensure that our humanitarian programs are appropriate and do not increase the risk of harm to program participants, particularly Gender-Based Violence (GBV). This means continuously monitoring these risks throughout the program cycle, building mitigations and controls into program design, implementation and closeout, thus reducing the likelihood of harm, exploitation and abuse.
“For example,” Davis explains, “in a refugee or IDP camp situation, we might build a block of latrines, but they’re not gender segregated, the paths to the latrines are not lit. There are no locks on the latrines.
“So even though we go in, and we’re providing the services, what we might be doing, not intentionally, is exposing women to and girls to gender-based violence, and we don’t want to do that.”
Habib (in green) receives a CARE package from a CARE staff member at an IDP camp. Divorced women face stigmatization due to their married status and CARE offers psychosocial support to them. Photo: CARE
When it comes to emergency preparedness and response in general, Davis would like to see a focus on resilience and anticipatory action in the global humanitarian sector and among the communities they serve.
“We are here to respond,” says Davis. “But by the time we’re responding, it’s already too late. We’ve lost lives, we’ve, you know, people’s livelihoods have been destroyed.”
Davis says investing in disaster risk reduction and anticipatory action is key. Like working with communities to come up with evacuation plans and early warning systems in disaster prone areas, and pre-positioning relief supplies ahead of time.
Though the cycles of war, conflicts and natural disasters will continue, Davis feels hopeful about CARE’s, and other humanitarian organizations’, presence in communities. Gone are the days of “truck and chuck,” where an organization drops in aid and then leaves.
These days, Davis says, “we are seeing a more deliberate attempt to truly first understand people’s needs. To listen to them and understand that communities are complex. I’m happy that we’re doing it better. We’re shifting power to local actors, instead of being, you know, Westerners that show up to save the day and then leave. We are helping to build resilience and respond better by empowering communities.”
“So many people who are in some of the worst situations humanly imaginable are the most optimistic and hopeful and resourceful people out there. If we put vulnerable people at the forefront of change and give them even a fraction of the resources that we have, that we throw away in leftover food, or instead of buying a new upgrade on our phone, for example, if we just put aside a little bit of that, it will make a huge difference.
“I see the kids who are in the refugee camps all over the world, and I don’t see hatred in them. I don’t see them saying things or have feeling things like, ‘the first thing I’m gonna do when I get out of here is get revenge on the person who kicked me out of my home.’ That’s not what refugees say. That’s not what I’m seeing. What I’m seeing is: ‘if I had a moment, if I had a chance, I would go back, I’d rebuild it better. I would make sure nothing like this could happen again. I would help anyone who’s displaced, anyone who’s a refugee.’
“That’s the hope for me. Knowing that the people who are the most affected, they themselves want us to move forward into peace, into prosperity, into change.”
– Emtithal “Emi” Mahmoud
Emi Mahmoud is a Sudanese American and former refugee who is a celebrated poet, activist, founder, and UNHCR Goodwill Ambassador who now lives in Philadelphia. Her refugee experience is singular, though not atypical.
Emi was born in Khartoum, the capital of Sudan, and her family is from Darfur. Her mother is a medical lab technologist and her father is a surgeon. When she was one year old, she and her family escaped to Yemen. Sudan was in the midst of its second civil war.
After several years in Yemen, when Emi was 4, she and her family were able to enter the US having been awarded visas through the US Diversity Visa lottery. They settled first in Virginia where a few other family members resided, then moved to Indiana, then Philadelphia where she has lived since.
Emi attended preschool in the US, then kindergarten, and in 2000, before starting first grade, she, her younger sibling, and her mom went back to Sudan to visit family when she experienced a harrowing life-changing event:
“I remember hiding under the bed with my sibling and cousins. I remember, I just remember so much. I wrote about it in this poem called People Like Us. I remember the blood on the soldiers—the blood on their ankles. But I just remember that there was blood. We were hiding, and these young girls came knocking on our door. We thought it was the soldiers, but it was these two girls, and they said, we have to hide now. Because after the people protested, the army chased them into the town, and we were kids home alone, and we didn’t really know what was going on. So much of what I saw and what I learned, what we experienced, is a lot of what essentially changed childhood for me, and what it was like, or what it meant.”
After 6 months, they were able to make it back to the US safely and she started first grade.
“And I just remember everything being different from then. You just have to pretend like nothing happened. It was very, very hard…” she reflected. “I remember my first-grade assistant teacher asking all of us like, ‘Oh, so what did you do over the summer?’ And so, I just completely made up a story. I said I went to Sudan, and then the rest of it was just all a lie. I said that we had a pet monkey and my sister liked to eat bananas, but the monkey kept taking the bananas, you know, and the teacher was like, Wow! And he just moved on.”
Now as a UNHCR Goodwill Ambassador, and through her award-winning writing and powerful performances on global stages, including the UN General Assembly, COP, the World Economic Forum in Davos, and the Women’s Forum in Paris, Emi has raised awareness of the global refugee crisis, creating empathy, and advocating on behalf of the forcibly displaced.
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UNHCR, the UN Refugee Agency: A Rich History of Helping Refugees
During the Second Sudanese Civil War, roughly two million people died from fighting, catastrophic hunger crisis and disease caused by the conflict between the northern part of Sudan and the south, and eventually led to a referendum resulting in South Sudan gaining independence from Sudan in 2011. Four million people in southern Sudan were displaced at least once, normally repeatedly during that war. The civilian death toll from that time is one of the highest of any war since World War II and was marked by numerous human rights violations, including slavery and mass killings.
Chad / Darfurian refugees from Sudan / Djabal camp (17,766 refugees, 4,681 families), 4 kilometers west from Goz Beida UNHCR sub-office located 217 km south from Abeche, located 900 kilometer east from N’Djamena the Chadian capital. The camp, created on 4/6/2004, is located 80 km from the Sudanese border. Ahmed Mahamat Khamis, 8 years old, on his way back home from the grocery where he bartered millet for sugar and onions. He carries in a bucket on his head a bag of sugar, some onions (in plastic pocket) and the “change”: some millet. The barter economy is common practice in the camps. A refugee brings a product to the grocery to get what he lacks (sugar, onion, soap,…). A koro of mill (measure of a big iron bowl) is equivalent to 400 CFA (0.85 USD). Photo: UNHCR / F. Noy / December 2011/ CC by 2.0
As of September 2023, globally those displaced by war, violence, persecution, and human rights abuses stood at 114 million, well over double the figure of 10 years ago. The number of people forced to flee their homes has increased every year over the past decade and stands at the highest level since records began, a trend that can only be reversed by a new, concerted push towards peacemaking.
“The situation of civilians in Sudan and in Ukraine, including millions who are refugees and displaced, demands our attention and support,” said Junia Geisler, Senior Director of Communications at USA for UNHCR, “as do protracted crises like the plight of the Rohingya, the Syria situation, Afghanistan, the ongoing struggles in the Democratic Republic of the Congo, the growing insecurity in the Sahel, the dramatic population flows across the Americas, the Mediterranean and the Bay of Bengal, and many others.”
UNHCR knows. They have been on the front lines of providing vital protection and assistance to refugees, asylum-seekers, internally displaced, and stateless people since 1950. Formally known as the Office of the High Commissioner for Refugees, UNHCR was established by the General Assembly of the United Nations in 1950 in the aftermath of the Second World War to help the millions of people who had lost their homes. Today, UNHCR works in 135 countries and provides life-saving assistance, including shelter, food, water, and medical care for people forced to flee conflict and persecution, many of whom have nobody left to turn to.
In addition to emergency response, UNHCR works with many local partners around the world on local integration programs which benefit both host communities and refugees. A great example of this is the Local Integration Program in Mexico led by UNHCR and supported by USA for UNHCR that gives refugees and asylum seekers in Mexico the resources and opportunities they need to start rebuilding. The goal of this program is to provide an option for refugees who are interested in integrating into communities in Mexico. The initiative supports refugees from their arrival all the way through to naturalization.
“Depending on the circumstances of those participating in the program, UNHCR either offers relocation within Mexico, or they offer integration support to refugees wherever they reside,” says Junia. Since the beginning of the program in 2019, more than 30,000 refugees and asylum seekers have participated in the relocation option and more than 80,000 have received integration support in their city of residence. Currently, the program is active in 21 cities across the country.
A Refugee Processing the Unthinkable
Emi’s parents did what they could to shield her and her sibling, Fofo, from the atrocities happening around them. “Every day, every morning they’d play a little piano keyboard and sing to us, and then they’d go to work, and you know we were refugees hiding in Yemen, and we didn’t know what was going on because we were kids, but my parents tried to make it as innocent of a childhood as possible.”
“It was a time after that before I started really processing what happened,” she remembers. “[When I was young] I liked science, and I wanted to be a paleontologist, and then I changed my mind to neurosurgeon, and I wrote poetry. I wrote poetry when I was 7, and then it changed when I was 10, when I found out about the conflict. And then my poetry changed from being about innocent things like lions… then it started to be about the war in Darfur.”
Emi gained a lot of recognition and prominence with her spoken-word poetry – a more powerful and accessible modality because you hear the words spoken how they are intended to be heard (and it connects back to oral traditions in Sudan and many other cultures). Hearing and seeing the poet recite a piece, “you essentially transport them to the moment you’re talking about,” she explained.
“In college I was doing slam poetry (spoken word poetry in competitions) and by senior year I had entered the individual World Poetry championship, and I won, and I became the youngest one ever to do that. So that was the first world record that I broke, spoken slam poetry. And then I won the Women of the World championship right after that. And so, I broke another world record because I was the youngest one to do that.” And, she is the youngest and only person to have held both records simultaneously as well.
In between, Emi became one of BBC’s 100 most inspirational women and gained even more recognition for the work she was doing.
Then one day in her senior year, she received an email that altered her life in profound ways.
A Life-changing Invitation
Emi received the email from UNHCR, inviting her to join them in Geneva for the Nansen Refugee Award. (Established in 1954, the UNHCR Nansen Refugee Award “honours individuals, groups and organizations who go above and beyond the call of duty to protect refugees, as well as internally displaced and stateless people.”)
UNHCR invited her to visit areas where they work. She went to Lesvos, Greece, “and again everything changed. It was just very, very harrowing to see how much had been done to everyone, and how it was all gone in that moment. I saw all of the life jackets and so much more. And I saw the work that our Nansen Honoree was doing that year.”
(The 2016 award recognized Greek volunteers Efi Latsoudi and the Hellenic Rescue Team and the work of all volunteers in Greece and Europe in 2015, when Europe faced its biggest refugee crisis in decades, as over one million people arrived during the year. Over 850,000 people reached Greece by sea, with more than 500,000 of these arriving on the island of Lesvos alone.)
“It was the first engagement [with UNHCR], and I wrote something about what I saw there, and I performed it at Nansen.”
She wanted to do more, “because in that moment I felt like I was standing on the other side of so many struggles just like mine,” she said. “I remembered that when I was a kid my parents were the ones speaking about it, and nobody believed us at first, but the first people to believe us were survivors of other conflicts… It was that we were related, all of us, we were in the same boat. And I remember it was this moment of unity and moment of understanding.”
She sensed a recognition with other refugees, between people who have gone through similar struggles, whether it’s different time periods, different peoples, or different contexts. And it helped her gain a deeper understanding of her childhood experiences.
This wasn’t her only eye-opening moment. Earlier, in 2013, in her freshman year of college, Emi gained deeper awareness when she went to Al-Fashir, the capital of Darfur, and worked in a birthing hospital in a refugee camp.
“I understood then that it’s not enough to be a good doctor. The limiting factor isn’t how well you do what you do, or how much knowledge you have to take away pain and such. If you don’t have medicine, if you don’t have supplies, if you’re working in a literally half-built hospital. If you are dealing with centuries of inequality that’s coming to fruition. There you get stuck. And so, I understood right then and there that I would need to have more reach and more knowledge and more collaborators to be able to make any kind of difference in any space, at all.”
As a UNHCR Global Goodwill Ambassador, and one of the first who was a refugee, Emi now has more ability to affect change – or more succinctly, how she can channel her energy to affect change she wants to see.
The True Value of Peace
Now that she is “at the table,” she understands international law better, and how different governments interact with each other, how different INGO’s operate. She also realized that she had an opportunity to evolve her role from not just building awareness and inspiring empathy – which is the main formula of the Goodwill Ambassador role – but to go beyond in a way that will really change the status of refugees and displaced people around the world.
“It’s not just about empathy or compassion. It’s about shifting perspective and shifting the paradigm.”
Now, when she meets with heads of state she talks about the benefits of helping refugees resettle, with a new message: “here’s why helping refugees and helping displaced people – here’s why setting a precedent for our world in general – can actually change the world for the better and affect all of us in the long run. When I go in there, I say it’s not just the right thing to do, but it’s a smart thing to do economically. It’s a smart thing to do geopolitically. It’s a smart thing to do from a humanitarian perspective. And it’s a smart thing to do for our future.”
Just as war is a de-stabilizing force, causing economic hardship and exodus, peace is a stabilizing force resulting in economic stability, growth, and prosperity. There is true value in peace.
“Peace is not just a word, peace is a tool that we could use to rebuild our world,” she told me.
And many times it takes deeper discussions to help others truly understand what it is like for those whose lives are disrupted and threatened, to understand why it is important to help. The civilian populations forced to flee simply want peace, to move back to their homes, and to get back to their lives. In Sudan, “if given the opportunity, if given the safety, they’d go back home and rebuild it like we were already doing or starting to do after 2019,” observed Emi.
Chad / Darfurian refugees from Sudan / Oure Cassoni camp (Head of Office in Bahai said 31,800 refugees, december 2011), 18 kilometers north from Bahai UNHCR sub-office located 361 km north-east from Abeche, located 900 kilometer east from N’Djamena the chadian capital. The camp is located 17 km from the Sudanese border, and was opened in July 2004. A couple of female refugees go with difficulty because of the sandy, cold and strong wind to the well in Oure Cassoni to fetch water. Photo: UNHCR / F. Noy / December 2011 / CC by 2.0
Most wars start without the consent of the affected populations. Refugees don’t choose to be displaced. Climate refugees don’t choose to leave their homes due to flood or drought. No one chooses to become a refugee. Refugees are people who are forced to leave their home country due to persecution, conflict, violence or other circumstances that threaten their safety and life. The risks to their safety and life were so great that they felt they had no choice but to leave and seek safety outside their country because their own government cannot or will not protect them from those dangers. And refugees have a right to international protection.
Dispelling Misconceptions, Shifting Perspectives
There are still a lot of misconceptions about who refugees and displaced people really are, Emi said, and this is one of the most pressing problems she sees about the plight of refugees and displaced persons.
“There’s the clear stuff that people see on the news, that there’s a crisis, that emergency aid is needed. But imagine being a refugee, and you don’t have soap and you can’t shower, or you can’t wash the few clothes you have. Or you have a baby and you have no diapers and you have to change your baby’s diaper, or in some cases through distributed aid you can get only one diaper a day.”
Especially problematic is if you lose your papers, your passport – one of the main elements that define your place in this world today – that you belong.
These situations are not captured by the media or shown to the world. But these are very real situations that refugees and displaced people must deal with every day.
“And so, all of a sudden, not only your autonomy goes out the window, but your dignity. And the humanity that is between us… I think one of the most powerful and most important things that I hope to help people understand is that refugees and displaced people are part of the world.”
And we live in this world, we are part of this world, she continues, “and what’s so painful about that is that people start to just expect refugees and displaced people to be the responsibility of organizations that are mandated to deal with or support refugees and displaced people.”
“I think that refugees and displaced people – that vulnerable people in general – are the responsibility of all of the world because it is a measure of our world. And it’s something that is part of our world, and us allowing it to go without help, without support, allowing people to be forced from home, or killed, or to die from lack of access to food or safety, and allowing it to happen, is essentially condoning it.”
“We’re essentially setting a precedent and saying that we are comfortable living in a world where, if tomorrow, Americans were forced out of their home and had nowhere to go, it would be totally fine if the rest of the world turned our backs, turned their backs.”
We Are in This Together
“There’s stuff that we can move forward together that none of us can move alone, and that’s what keeps me in it. I don’t think anyone who really knew what was happening, wouldn’t try and do something,” Emi said.
She was reminded of a quote by a former UN High Commissioner for Refugees, Sadako Ogata: “There are no humanitarian solutions to humanitarian problems.”
“A lot of people believe that means that there’s no solutions to humanitarian problems,” Emi explains, “but that’s not what it means at all! It means that there are no humanitarian solutions because these problems aren’t created by our humanity. And I think a lot of people miss that point when they hear that. ‘Humanitarian problems’ is a misnomer because they’re not created by humanity, they’re not created by humanitarianism. They’re created by imbalances. There are political solutions, there are economic solutions, there are state solutions that could help fix it.”
We asked Junia Geisler, Senior Director of Communications at USA for UNHCR, what’s the best way for an average American to get involved in helping refugees? Here are her answers:
Donate. USA for UNHCR helps to protect refugees and people displaced by violence, conflict, and persecution. We support UNHCR, the UN Refugee Agency, in providing lifesaving essentials for refugees including shelter, water, food, safety and protection. During an emergency, your donation ensures that UNHCR can send relief supplies and cash assistance vulnerable refugees and displaced families. Even small amounts make a big difference.
Advocate. Join our global community of advocates who are standing with refugees. You can support refugees with your voice by engaging with elected officials and community leaders to protect refugee rights and ensure they are welcomed into your community. By advocating for refugees, you are empowering them to rebuild their lives.
Welcome. A refugee’s story doesn’t just end once they’ve been resettled in a new country. After their long journey to safety, they still need your support. You can welcome new refugees who are arriving in your community by offering shelter, support or even a job. Look for volunteer and sponsorship opportunities near you to support refugee families.
Connect. The more we understand, the greater sense of belonging we create. Stay up to date on situations around the world—from Afghanistan to Sudan and Myanmar to Ukraine. Learn more about refugees and emergency situations from reliable sources and share that information with your networks to spread awareness and empathy.
By Jason Hatch and Karen Kraft, Operation Snow Leopard
Interior of the newly inaugurated Wolesi Jirga Hall of Afghan Parliament (Photo Credit: Wolesi Jirga Website 2015)
Background
The Fall of a Republic
The last tragic iteration of a democratically elected government in Afghanistan came to an end on 15 August 2021.
It had been established in 2005, with its electoral branch consisting of a lower house (Wolesi Jirga – 250 seats) and an upper house (Meshrano Jirga – 120 seats). The Afghanistan Constitution, ratified in 2004, explicitly stated that men and women had equal rights and duties before the law. It reserved specific seats in both chambers for female candidates, reflecting a commitment to gender equality supported by male leaders advocating for women’s representation in the newly formed republic.
By Radwa el Manssy, ChildFund Director for Protecting Children in Crisis
Migrants, refugees, commuters and cargo cross the Suchiate River that forms the border between Guatemala and Mexico. Photo: Jake Lyell for ChildFund
Lately, I have started to collect what I sometimes call “fairy tales” when I visit the areas where my organization, ChildFund, works with children and families who have fled their homes for a better, safer life. One girl I met in Mexico had come all the way from Colombia. I said to her, “Oh, you must be tired!” But she was so optimistic: “We’re very close!” She told me her love story, about a boy that she had left behind.
