Stories from the Field

Today, February 4th, is World Cancer Day. All around the world people and organizations are marking the occasion by raising awareness and funds to combat what remains one of the leading causes of death. Human Concern International has been active in this universal cause. Recently, we encouraged breast cancer screening for women in Gaza in co-operation with the Aid and Hope Centre for the Care of Cancer Patients. Early detection of breast cancer is the key to effective treatment, and reduced fatalities. Now, we are continuing our effort by supporting Egypt’s largest and most effective children’s cancer hospital, The Children’s Cancer Hospital Egypt (57357). Please join us, and the countless others, who are working towards a future without cancer.

Cancer kills 7.9 million people every year, and is the leading cause of death for children between the ages of 1-14 worldwide. Tragically, many of these deaths are entirely preventable. In the developed world, the advent of new treatments has seen cancer survival rates steadily climb, but, as with so many other things, these treatments are not available in much of the developing world. The result is that children in Egypt, for example, are twice as likely to die from cancer as children in North America. One cannot imagine the pain families must endure when their child is lost simply because he or she did not have access to adequate medical care.

In Egypt, a country of 81.5 million people, only 350 hospital beds are dedicated to treating child cancer patients, and no more than 100 physicians have received pediatric oncology or hematology training. It is one of many nations which do not devote enough funds to pediatric oncology out of the misguided belief that it is prohibitively expensive, and resources would have a greater effect elsewhere. This simply is not the case, as a recent study by St. Jude’s Children’s Research Hospital has demonstrated that even a small increase in funding can dramatically improve survival rates. Prevention and early diagnosis programs are highly cost effective, and do not require advanced technologies. Despite the evidence, the World Health Organization does not have any program in place to correct the huge disparities in cancer survival rates worldwide. The result: children in the countries like Egypt continue to die unnecessarily.

Psycho-social support for child cancer patients, and their families, is particularly lacking in Egypt. It is considered merely as an afterthought, if at all, and families must often face the emotional challenges of cancer without professional support. Adding to this is the stress resulting from poverty, and the daily struggle to gather adequate funds to pay for treatment. Many families simply cannot bear the emotional or financial burden, and as a result they abandon cancer treatment programs for their children prematurely.

The Children’s Cancer Hospital Egypt (57357) has taken it upon itself to correct the imbalance, and ensure that even the poorest children of Egypt have access to the same life saving treatments and support as their more fortunate counterparts. Operating since July 7, 2007, it is now the largest pediatric oncology centre in the Middle East and Africa. Its facilities include Egypt’s first specialized department of physiology, social work, and psychiatry for pediatric oncology. Creating a single hospital devoted to pediatric oncology has enormous benefits. The hospital staff is both highly trained and highly motivated. It has created a nucleus for training new physicians, carries out groundbreaking research, and provides top level treatment. By collaborating with experts worldwide, the hospital is able to integrate the most advanced medical knowledge into its treatment of patients.

The hospital has recognized the need not only for state of the art medical care, but also for a more comprehensive approach. As such, it has inaugurated the country’s first school program for hospitalized children, to ensure that they will be given the chance to succeed once they have completed their treatment. It provides support to families as they struggle to cope with the stress of a cancer diagnosis for their child. Hospital staff work with the community to raise awareness about cancer screening, and early detection, as a way to improve survival rates, and save the lives of countless children.

CCHE serves all Egyptians, regardless of their ethnicity, religion, or ability to pay. All treatments and medications are provided free of charge if a family lacks sufficient financial means. Also, economic support is given to families who must often travel long distances to visit their children undergoing treatment, and who would otherwise be unable to afford the journey. Housing and job opportunities are provided when necessary. All of this means that now less than one percent of patients abandon treatment, whereas economic hardship previously caused almost 16 percent to not finish their programs. The hospital is a model which should be followed throughout the Middle East, and the world.

Human Concern International, in recognition of the hospital’s achievements and vision, has provided them significant financial support. The hospital is committed to sustainability, and we can be certain that no dollar will be wasted. It is money that will be used to help the hospital to expand, bringing its life-saving treatment, education, and message to ever larger numbers. We wish the hospital the best of luck, and are privileged to aid such a worthy program. We are certain that they will continue to provide high quality care to all those who need it for years to come.

Last Sunday the streets of central Beirut were transformed by the Beirut International Marathon. For one day they were devoid of traffic, as people of all ages, religions, ethnicities, and nationalities walked and ran side by side. They turned the streets into a sea of people, all of them willing to sacrifice their time and energy in support of a cause. On that day HCI spread its message of healthy living to the more than 33,000 people in attendance. We sponsored underprivileged children to run in the marathon, encouraged them to exercise, and inspired their peers to do so as well. The HCI team made up of children aged 9 to 17 from rural Lebanon, many of them orphans, ran together to promote our campaign. The spirit shown by these children, who participated with boundless energy un-dampened by the rain, was perhaps the best advertisement for a healthier lifestyle.

This year’s Beirut International Marathon saw more than 33,000 participants, including, among others, the Lebanese President, Prime Minister, four government ministers, and many other Members of Parliament, brave the cold and the rain to come together and run or walk in support of a good cause. More than 4,000 volunteers also took part, including members of Human Concern International, a testament to the strong sense of community often displayed by the Lebanese. The marathon was truly for everyone, not only the professional athletes and victors. It was an event which gave many people the rare opportunity to run and exercise in a city where the absence of parks and public space makes it often very difficult to do so. For one day the sounds of car horns and the fumes from exhaust pipes were replaced by thousands of people singing, laughing, walking, and running. It was a demonstration of what can be achieved if we make the very simple choice to live healthier.

The Beirut Marathon provided HCI with a unique opportunity to spread our message to literally thousands of people. It was an opportunity that we did not miss. Before, during, and after the marathon participants and visitors received HCI’s awareness materials which encouraged Lebanese to take a second look at their diet, and, combined with our website (www.hcime.org/sahetna), provided them with all the information they need to start eating healthier. A 34-pages manual was produced to address all requirements for a healthy diet. “Food pyramid” posters were given to local schools, and placed in classrooms to let children know how much vegetables, fruit, grain, milk, oils and beans they should eat everyday. Children must know the importance of eating healthily, and these posters give them the knowledge they need in a colorful and engaging way. In the days and weeks leading up to the Beirut International Marathon, HCI utilized a booth in the heart of Beirut to distribute printed materials, and meet face to face with both marathon participants and members of the general public. By doing so we were able to reach a large number of people, promoting a healthy lifestyle and a healthy diet. Through our website we were able to bring that same message to countless others.

In Lebanon and from the start we have encouraged healthy activities, as seen by our sponsorship of Beirut’s first ever Terry Fox Run in 1997. The Terry Fox Run, an event in which people of all ages come together for one day to run and raise money for cancer research, was only the first step. More recently we also implemented the national “Farm to School” project, which promoted healthy eating habits among school-aged children, along with many other objectives. Information is the key to combating the obesity epidemic. Better informed people make better decisions, and will lead happier, healthier lives.

The Beirut International Marathon happens only one day of the year, and reaches out to tens of thousands of people. On that day HCI did what it could to promote a more active lifestyle and a healthier diet, but in order for our advice to be effective it must be followed the other 364 days of the year, and reach millions of other Lebanese. Obesity is a serious problem that deserves serious attention. We must all pay more care to what we eat, and start to exercise regularly. HCI can provide the information you need in our online healthy eating guide, including ten recipes for specially developed nutritious meals which use ingredients easily available throughout the region, but only you can make the choice to change your lifestyle. Doing so will give you a longer, healthier, happier life, and help prevent what may soon become the most serious epidemic on earth.

Jabal Akroum is one of the poorest and most marginalized areas of Lebanon; it is remote, difficult to reach and underdeveloped. It is located high up in the mountains of the Akkar district which has seen several conflicts back-to-back; in 2006 there was the July War in which all of Lebanon was affected and in the summer of 2007 there was the more damaging Nahr Al-Bard conflict which dealt a devastating blow to the local economy. It is estimated that seventy three percent of the population of Jabal Akroum live below the poverty line.

In an attempt to care for and support the children affected by poverty and conflict in this area, HCI together with local partner Jabal Akroum Association, organized an excursion for one hundred boys and girls from eight villages in the Jabal Akroum area this August as an intervention to address their psychosocial wellbeing, which is a very important factor that if neglected can lead to reduced social connectedness, coping skills and resilience, this in turn places children at risk of isolation, apathy, drug or substance abuse, truancy, self-exploitation, and criminal behavior.

The children, mostly orphans from underprivileged backgrounds and their supervisors were transported by buses to the northern city of Tripoli for a fun filled day. The first activity of the day was a trip to an amusement park which was reserved for them in advance; they were given access to all the rides and games. The children laughed, ran about, played and generally seemed excited. Many of them told us that this was their first visit to an amusement park, and their first time in the city.

After the amusement park the children left, (albeit a little reluctantly) to go the Al Mona School, where HCI local partners CIWS had especially set up a dining hall and prepared a healthy meal for the occasion. The meal was prepared as part of HCI’s Farm to School project — where school-aged children receive nutritious meals, learn about the path from farm to fork and are provided with essential information on healthy eating habits. After an active afternoon of fun and games, the children looked quite happy to take a short break for lunch and refreshments.

As the children got back on the buses to be transported to the port of Tripoli for the final stop of the day, their excitement was palpable and justified; many of them had never ventured far from their villages in the mountain and had only heard about the sea in stories or seen it on television. Once at the port, they observed their surroundings with awe as they walked along the shore and saw the fishermen at work. When it came time for them to take a boat ride along the coast, awe turned into pure unbridled elation. The children’s happiness was so intense that it was contagious; all the on looking boatmen and fishermen seemed to be wearing smiles almost as broad as those of the children.

Every child deserves to be healthy; the proverb “healthy body, healthy mind” says it all; access to a good nutritious meal and developing healthy eating habits are vital for every child’s well being. In 2009, HCI introduced the “Farm to School Program” in Lebanon, where small scale farmers, low income students, and unemployed women living in rural areas were all linked in a holistic socio-economical cycle. The approach of the program has proven its efficiency and is a great success as stated by the beneficiaries themselves. To this date, hundreds of school-aged children have received several nutritious meals, learned about the path from farm to fork and have been provided with basic necessary information on healthy eating habits.

The program was specifically designed to target low income school-aged children, most of which are direct victims of war and scarcity and have to bear the difficult consequences of violence and deprivation that affects them and their families on many levels; whether on the income provided by the head of the family or on the quality of their meals at home. Dietary deficiencies can affect short-term health, increasing the risk of dental problems, obesity and anemia. In the long term, poor diet may increase the risk of coronary heart disease, strokes and diabetes. Some cancers are believed to relate to a low intake of fresh fruit and vegetables. Under-nutrition, even in its milder forms can have detrimental effects on cognitive development, behavior, concentration and school performance.

While implementing the Farm to School Program it was evident that complementary awareness raising activities concerning education and health should be implemented with the parents and care givers of these children giving them valuable essential tips on: healthy eating practices, food safety, hygiene and how to promote healthy eating and lifestyle habits, that can last a lifetime through specially designed engaging workshops and printed materials; Human Concern International is proud to announce the completion of the “Sohatak Bel Deni” manual, providing parents, teachers and caregivers with detailed essential information about cooking healthy food at low cost among other things.

The specially designed manual is a result of research done by a team of nutritionists and agricultural engineers and takes into consideration the access of the low income households to certain food items, as much as it takes in consideration the lack of access of these families to healthy living choices, and the common misconceptions about what is nutritive and what is not. The manual explains the ABC’s of what is healthy and what is not in an accessible format, it should be noted that the manual is not designed to alter the lifestyle of these families, but rather to reorganize their eating habits while keeping their financial budget intact.

The thirty-one-page Arabic manual is full of valuable information; from easy to understand food pyramids to recommendations on healthy eating habits such as consuming Omega 3 rich foods at least twice a week, from food safety advice such as the best way to handle and store poultry, to healthy cooking practices such as the use of vegetable oils instead of traditional ghee. A menu suggestion with recipes for healthy versions of traditional foods such as Okra stew and yoghurt salad is also included, each with its own calorie, Protein and carbohydrate breakdown. HCI did not forget to include an activity page for the children to color and have fun while learning.

Human Concern International is proud to publish and distribute this resource to enable communities, schools and caregivers to plan better meals for their children and by doing so contribute to their general overall physical and mental health and to their school attendance. The Arabic manual will be launched in various low income and rural locations around Lebanon, complemented with specially formulated awareness raising sessions held by qualified nutritionists; it can also be downloaded here free-of-charge in PDF format (7.74 MB): Sohatak Bel Deni Manual

The “Farm to School program brings healthy food from local farms to thousands of poor school-aged children in low-income remote villages. Moreover, the program teaches students about healthy eating habits that can last a lifetime. In addition, the use of local products in school meals and educational activities provides a new direct market for local low-income farmers. It also provides local women with temporary jobs in food preparation,” explained Abdo Raad — the director of Saint Saveur School and Orphanage. The school, located in the city of Joun, south of Lebanon is home to 70 orphans and vulnerable children and hosts 150 school children.

“It is a win-win situation for everyone,” he concluded during the inauguration ceremony of the kitchen supported by the German Embassy in Lebanon, as well as the opening of the third Lebanese-Palestinian youth summer camp which hosts Palestinian youth from camps in Lebanon, Syria and the Palestinian territories.

“We thank HCI for this important initiative which is vital for the revival of low-income remote areas,” commented H.E.M Brigitta Eberly, the German Ambassador to Lebanon who attended the ceremony.

The German Embassy in Lebanon contributed over $16,000 to equip the kitchen at the premises of the school/orphanage which will help HCI’s Farm to School project expand its scale and scope to reach out to other schools and orphanages in nearby villages, which is expected to benefit more than 700 children during the summer of 2009.

The inauguration ceremony was attended by H.E. Mrs. Bahia Hariri, Minister of Education and Higher Education and H.E. Mr. Mario Aoun, Minister for Social Affairs.

“Cause and Identity” is the theme of this year’s Lebanese-Palestinian youth summer camp which coincides with the celebration of Jerusalem as the 2009 Arab Capital of Culture. The 40 Lebanese and Palestinian youth come from different regions in Lebanon and from Palestinian camps in Lebanon, Syria and the Palestinian territories.

“Building bridges and trust and creating a platform for dialogue and sharing among Lebanese and Palestinian youth is the main objective of this summer camp,” H.E. Mrs. Hariri, the President of the Hariri Foundation for Human Sustainable Development (HFHSD), explained during a discussion with the participants. HFHSD is sponsoring of the summer camp.

The Lebanese Ministry of Education and Higher Education has been actively working in the past two years on integrating health and wellbeing topics into the Lebanese school curriculum, especially for elementary school students. “HCI’s successful Farm to School project which promotes healthy eating habits for school-aged children is a significant initiative that the Ministry of Education should consider adopting to improve student health,” suggested, Rabih Yazbeck, HCI’s Regional Director, during a conversation with the participants. “We hope that the summer camp’s attendees will benefit from our initiative, and take what they’ve learned back to their families and help bring awareness in their surrounding environment,” Mr. Yazbeck concluded.

The Farm to School Project was launched this March in two regions in Lebanon. To this date, thousands of school-aged children have learned about the path from farm to fork and healthy eating habits.

The program desires to support community-based food systems, strengthen family farms, and provide jobs for vulnerable women and nutrition for poor students hence contributing towards their health and well-being.

The family farm owners will have a chance of securing a steady income, the students will be motivated to get an education, and the unemployed women will have the opportunity of working and generating income. These benefits are not limited to economy and education, but also affect the overall morale of the residents.

On the long-term, the program will introduce waste management programs like composting, and experiential education opportunities such as planting school gardens, cooking demonstrations and farm tours.

What we are witnessing here are the combined efforts of the public and private sectors, and the civil society, local and international. These initiatives transcend all national, religious, and racial differences and have one aim in mind, the well-being of our children and families. At the end, humanity is the bridge that connects us all, and it lies ahead in anticipation of the courageous many who will attempt to cross it.

In May 2009, the HCI team launched two projects in Sudan that will provide credit capital and the necessary training and coaching to two new communities in two settlements in the south and the north of the capital Khartoum as well as a project which will promote entrepreneurial spirit among impoverished Sudanese orphans, and giving them the proper training in setting up and managing their own small businesses. Human Concern International has always made an effort to work with poor communities in Sudan; with 2 million Sudanese at risk of death, in addition to those who have been injured, displaced and have lost all of their support and care networks due to the continues civil unrest, poverty and lack of proper infrastructure, one should feel concerned. The living conditions in these settlements are extremely unsafe; while visiting the community leaders, we witnessed the cruel effect of poverty on people; in these two settlements people had built their houses from scrap metal, water was insufficient and unclean, sanitation services were nonexistent and the scarcity of food was visible on the children, someone even pointed out those dying from malnutrition.

This difficult image that we witnessed will soon be changing with these projects that were launched in partnership with several local long-time partners in Sudan, including Peace and Development Volunteers (PDV) and African Charity for Child and Mother Care (ACCSOM). One project will assist the rebuilding of Sudanese lives through micro credit, and provide access to finance programs for low-income Sudanese widows. The second project aims to unlock and unleash the economic potential of Sudan’s orphans that HCI has been sponsoring since 2003. Through the micro-credit initiative: 100 widows will receive loans for income generation and small businesses, 2 revolving loan programs will be established and will be operated by local communities, 2 local credit committees will be established at two targeted communities, and 16 people at two local credit committees will receive training in basic credit provision.

The second project’s objective is to assist orphans shift their mindset from being passive receivers of donations to active income generating entrepreneurs. Instead of being drawn into a passive cycle of receiving charity and relying on the kindness of others, 30 orphans will receive the training and materials necessary to embark on their own business ventures. They will also be given the opportunity to test their ideas under real-life circumstances, and take part in the “Business for a Day” program, in which they will operate a business for one day. An investment club, run by the orphans, will be set up. The club will be endowed with a trust fund, which will be invested towards implementing club activities. Thirty orphans, fourteen years of age and older, will take part in the first phase of the program.

The implementation of these two projects will provide the solid ground on which these widows and orphans can build their lives on, where the knowledge and the technical assistance will be provided by the project’s workshops and volunteer trainers and the revolving funds and loans will be in the hand of their own community to make use of, nurture and pass on to other needy members of their community to slowly but effectively reduce poverty levels within these two settlements.

Our field visits were not only to launch new projects, but to also follow up and connect with other local partners in these two settlements, where HCI has long been implementing relief and development projects that offer Sudanese orphans economic security through the child sponsorship program; where devastated, left out and marginalized orphans are given access to food, security and education throughout their sponsorship period. Our local partners took us to a library that HCI helped establish, where many of the sponsored children are able to have access to knowledge and information.

During the same visit, HCI and the Canada-based International Development and Relief Foundation (IDRF) launched a new interesting initiative in Sudan, related to International Water & Sanitation (IWS) and targeted in the first phase at building the capacity of Canadian international institutions in this area of technical assistance. To have a better understanding of the situation, HCI will prepare a comprehensive country analytical report in partnership with HCI local partner, Peace and Development Volunteers (PDV). The result of the report should formulate the ground in which HCI and other Canadian based organizations can implement large-scale interventions in Sudan to ensure water sufficiency, and opportunities for related income generating activities. Projects like these are vital and have the potential to fundamentally change many lives, especially in impoverished settlements like these ones. HCI also witnessed the launching of a new civil society-public partnership for the provision of family-based health insurance that our partners are engaged in.

In the last part of our very dynamic and productive field visit, we also got the chance to visit the health clinic that was established with the help of HCI to serve the new settlements in northern Khartoum. The health clinic has outstandingly been operating autonomously, self sufficiently and effectively to serve the population with a professional team of health experts that are semi volunteering to cover the health needs of the area, from treating chronic illnesses to dental care. During our visit at the clinic, we came across a group of young boys in the process of being circumcised; our local partners explained the importance of having such traditional operations take place in a clinic by the hands of medical practitioners, instead of having them done the traditional way in an unsanitary environment that often yields harmful outcomes. Wandering around the clinic, we were content to see the staff operating professionally; taking care of the patients and maintaining the medical equipment to make sure that as many people as possible are able to benefit from it.

It was a busy week in the field in Sudan, but those few days have made us more confident after seeing the efforts of our local partners to sustain themselves and sustain project impacts and use all the available opportunities to help their communities. As the humanitarian situation in Sudan is deteriorating, HCI feels obliged to double the efforts to provide immediate relief to those who are in need, especially those that are most vulnerable; orphans and widows.

On the 8th of March 2009, HCI worked cooperatively with its Gaza-based partner, the Aid & Hope Center for the Care of Cancer Patients, to celebrate the International Woman’s Day by promoting cancer early detection, particularly mammograms test which is among the best early detection methods for breast cancer among women. Breast cancer if detected early, the five-year survival rate exceeds 96%.

In Gaza, the awareness of breast cancer and opportunity for help is limited for women. Latest estimates show that less than 40% of breast cancer cases are detected early in Gaza - one of the lowest rates in the world. By promoting mammography test, Gaza women will have an opportunity to detect breast cancer when it is small, and when treatment options are available and a cure is more likely.

Mammography is a specific type of imaging that uses a low-dose x-ray system to examine breasts. Mammography play a central part in early detection of breast cancers because it can show changes in the breast up to two years before a patient or physician can feel them. Current guidelines from the international health bodies recommend screening mammography every one or two years for women, beginning at age 40, since the older a woman is, the greater her chance of developing breast cancer. Research has shown that annual mammograms lead to early detection of breast cancers, when they are most curable and breast-conservation therapies are available. When cancers are small, the woman has more treatment options and a cure is more likely.

The awareness campaign took place during the three-day fair organized by the Women Affairs Center, Gaza Chapter, under the slogan of “Despite the death and destruction, long-live the eighth of March: Exhibition of goods made by Gaza women.”

Thirty five women NGOs participated in this year’s exhibition, where 12 thousands women are expected to attend. NGOs are exhibiting their goods and products made by Gaza women.

Assisted by women volunteers from the Aid & Hope Center for the Care of Cancer Patients (AHCCCP), 900 women from Gaza filled in a questionnaire about breast cancer and they were given pink ribbons symbolizing the fight against breast cancer, donated by HCI. The team intends to complete 10,000 questionnaires by the end of the exhibition. The survey investigates, among other things, the current state of early detection of breast cancer, the mammography tests, and the perception of Gaza women in regard to the test.

Findings from this survey will help shaping HCI/AHCCCP’s future interventions concerning breast cancer early detection and the viability to implement a mobile clinic in Gaza specialized in mammography tests in the poorest and marginalized areas in Gaza.

For the past five years, HCI has been working for the well being of the estimated 11,000 internally displaced people of Salama settlement, who have fled the violence in the south and west of their country and now live south of the Sudanese capital of Khartoum. Here they face chronic poverty, both high unemployment and illiteracy, and many health problems. Their health is jeopardized by both poverty and the environment in which they live. Eyesight related diseases rank very high among children due to environmental and dietary habits, as HCI research found out, particularly due to the pollution of drinking water and dietary habits.

HCI new intervention in the area addresses this problem by implementing an eyesight health campaign targeting school-aged children in the area. The project conducted a needs assessment/research of health issues of greater concerns to the local community.

The first intervention addresses eyesight related disease and eyesight problems by implementing mobile clinics to provide eyesight medical checkups and provide them with medicines and eye glasses. Eye related first-aid boxes and medical supplies were also provided to families. Water tanks for safe drinking water were also installed at two schools. Hundreds of families and their children participated and benefited from this campaign.

In partnership with three local grassroots organizations and Peace and Development Volunteers (PDV), a local voluntary organization, hundreds of school-aged children benefited from this intervention to-date at two sites in the same area. A third campaign will be implemented later this month at a remaining third site. Such intervention allowed for the implementation of quick impact interventions that built confidence between the partners and provided solid ground to expand much-needed health interventions in the area.

HCI operation in this area stretches back to 2003. HCI has been helping people in the area through community-based organizations established by local residents. Since 2003, HCI has been working in this area on microcredit projects for women, school rehabilitation, education support, income generating activities and food and non-food distributions.

In partnership with local and international partners, HCI has been working on health programs in Khartoum since 2002, particularly in Dar-El-Salaam settlement north of the capital Khartoum and home to about 16,000 displaced people. This include establishing a fully operational health clinic providing health and reproductive services for over 33,000 patients; seven women trained in community health outreach, emphasizing nutrition and hygiene; three women trained as midwives; and nine as home visitors, benefiting nearly 4,000 families; health awareness training for 45 women, establishment of a health awareness committee, and surveys conducted on reproductive health.