MALNUTRITION: Viet Nam: Crucial Nutritional Support Helps Fight Hunger and Save Lives

17 Nov 2011 Source: member // AmeriCares

These happy faces say it all: 3,200 Vietnamese children no longer go hungry, thanks to a Pediatric Nutrition Program supported by AmeriCares and its partners. In Vietnam, where one-third of children under age 5 suffer from stunted growth due to malnutrition, this program is a shining example of hope and progress.
Sadly, there is much more work to be done to help families in developing countries around the world, where malnutrition is an all-too-common reality. Since 1985, when a deadly famine gripped Ethiopia, AmeriCares has played an active role in bringing lifesaving nourishment where it's needed most, with:
Immediate emergency deliveries of nutritional supplements to ease human suffering in famine-stricken Somalia, Kenya and Ethiopia
Ongoing nutritional support, programs and grants: to help children, expectant moms and families facing chronic malnutrition in El Salvador, Malawi, Vietnam, Haiti, and throughout the developing world.
Lifesaving Nourishment for Famine Victims in the Horn of Africa
As thousands of families facing starvation pour into refugee camps in Somalia, Kenya and Ethiopia, AmeriCares is scaling up its programs to combat severe malnutrition in the famine-stricken Horn of Africa. AmeriCares has rushed deliveries of enough nutrient-rich porridge -- especially beneficial for children under 5 and expectant moms - to provide 13,000 people with a daily supplemental feeding for one month. A therapeutic feeding center located in the newly constructed AmeriCares-supported field hospital in Kenya will ensure that the sickest, most vulnerable children and adults have access to continued nutritional interventions and lifesaving medical services. The semi-permanent facility, built and stocked by AmeriCares and operated by the International Medical Corps, is expected to be operational for at least two years.
Pediatric Nutrition Program Breaks the Cycle of Hunger in Vietnam
To combat high rates of chronic malnutrition in rural Vietnam, AmeriCares and its partners have supported a school-based Pediatric Nutrition Program that has improved the lives of more than 3,000 children ages 12 months to 5 years. Launched as a pilot in 2005, the program continues to expand, thanks to its remarkable success in reducing malnutrition rates and promoting growth in children facing dire nutritional challenges. Each child receives nutritious soy milk and protein-rich foods along with daily multivitamins and supplements. The program also provides health and nutrition training to students, teachers and parents to help break the cycle of hunger. Five-year-old Mi-Thien -- the first in her family to participate -- achieved such impressive height and weight gains that her parents enrolled her younger brother in the program "The soy milk is delicious and when I drink it, I feel full and good," said Mi.
http://www.trust.org/alertnet/news/crucial-nutritional-support-helps-fight-hunger-and-save-lives

MALARIA: Co-infections of Plasmodium knowlesi, P. falciparum, and P. vivax

EID Journal Home > Volume 17, Number 7–July 2011
Co-infections of Plasmodium knowlesi, P. falciparum, and P. vivax among Humans and Anopheles dirus Mosquitoes, Southern Vietnam

Ron P. Marchand, Richard Culleton, Yoshimasa Maeno, Nguyen Tuyen Quang, and Shusuke Nakazawa

Abstract
A single Anopheles dirus mosquito carrying sporozoites of Plasmodium knowlesi, P. falciparum, and P. vivax was recently discovered in Khanh Phu, southern Vietnam. Further sampling of humans and mosquitoes in this area during 2009–2010 showed P. knowlesi infections in 32 (26%) persons with malaria (n = 125) and in 31 (43%) sporozoite-positive An. dirus mosquitoes (n = 73). Co-infections of P. knowlesi and P. vivax were predominant in mosquitoes and humans, while single P. knowlesi infections were found only in mosquitoes. P. knowlesi–co-infected patients were largely asymptomatic and were concentrated among ethnic minority families who commonly spend nights in the forest. P. knowlesi carriers were significantly younger than those infected with other malaria parasite species. These results imply that even if human malaria could be eliminated, forests that harbor An. dirus mosquitoes and macaque monkeys will remain a reservoir for the zoonotic transmission of P. knowlesi.

Concerted control measures have considerably reduced the prevalence of malaria in Vietnam, and the parasites that cause it are now mostly restricted to forested rural areas (1). Forest malaria poses a special challenge for control because the exophilic and early biting habits of the mosquito vector Anopheles dirus render conventional vector control methods such as indoor residual spraying and insecticide treated mosquito nets difficult to apply as well as ineffective (2–4). The possibility of zoonotic malaria in Southeast Asian forests, because of the transmission of Plasmodium knowlesi from monkeys to humans (5–10), may form an additional complication.

Since surveys began in 2002, the forest populations of An. dirus mosquitoes in Khanh Phu, south-central Vietnam, have shown consistently high sporozoite infection rates (1%–2% of the thousands of specimens collected and dissected annually for microscopic examination of salivary glands), raising the question of whether all the sporozoites detected belong to species capable of infecting humans. In 2008, evidence was found for the co-infection of P. knowlesi, P. falciparum, and P. vivax in the salivary glands of 1 mosquito among 17 that had been processed by PCR with malaria parasite species–specific primers (11). Here we report the results of the PCR analysis of 72 additional sporozoite–positive salivary glands of An. dirus mosquitoes from the forest in Khanh Phu and of 211 blood samples from the local human population.

http://www.cdc.gov/eid/content/17/7/1232.htm

POVERTY: ASIA: Indigenous people gain greater forest rights

JAKARTA, 12 July 2011 (IRIN)


 Photo: Angela Dewan/IRIN
Indonesia is clearing its forests faster than any other country, Greenpeace says

More and more Asian governments are giving indigenous people greater control over their natural resources and habitat in a bid to stem deforestation, a new report states.
Countries such as China, India and Vietnam are making "dramatic" progress, not only in stopping deforestation, but also in expanding their forests, thanks to reforms that include giving more rights to communities and indigenous groups, according to the report by the Washington-based Rights and Resources Initiative (RRI) released on 12 July.
"The state remains the predominant actor in the region's forests, but the trend towards increased and legally recognized local control now emerging is incredibly important," Andy White, coordinator of RRI, a global coalition of groups advocating forest land tenure and policy reforms, said in a statement accompanying the report.
"It's no coincidence that the countries granting more rights to communities and indigenous groups are the same ones making progress toward more sustainable management of their forest resources," he said.
According to the report, The Greener Side of REDD+: Lessons for REDD+ from Countries where Forest Area is increasing, between 1990 and 2010, 78 nations in the world with significant forest cover either maintained or increased their forested areas.
REDD stands for Reducing Emissions from Deforestation and Forest Degradation, a global initiative to help developing countries reduce carbon released into the atmosphere by tropical forest destruction.
And while Nepal, Thailand and Cambodia have all increased the amount of land devolved to communities since 2002, the report says the pace of change in the region remains uneven.
Indonesia, home to the world's fifth-largest forested area, remains excluded from the promising regional trend, the report said. There are almost 30,000 villages on land claimed by the Indonesian government, yet communities have rights to less than 1 percent of the nation's forests.
Indonesia reserved 600,000 hectares for communities in 2002 but the area appeared to shrink to 230,000ha by 2008, according to government figures cited by RRI.
The new data shows that in 2010, fewer than 100,000ha had been legally recognized as under local control, far short of an Indonesian government target to devolve at least 500,000ha per year, the report said.

Signs of progress
But RRI also reported signs of progress. In the past few years, the country has made efforts to improve its policy, including creating a process for designating new areas as "community" and "village" forests that would be under local control.
Moreover, Indonesia is co-hosting an international forestry conference on Lombok island focusing on forest tenure and governance from 11-15 July.
That fact alone "says a lot about the realization at very high levels that the status quo is not a perfect one and it needs improvement", Boen Purnama, an adviser to the country's Forestry Ministry remarked.
According to Hedar Laudjeng, chief of community affairs at the government-sponsored National Forest Council, conflicts between local communities, companies and the government stem from unclear regulations governing forests.
"Foresty-related laws are not in favour of local communities, making the risk of conflicts high," he said in a statement at the start of the Lombok forestry conference.
http://www.irinnews.org/report.aspx?reportID=93203

TUBERCULOSIS: The ART of timing: treating HIV-associated infections

12 Jul, 2011 : Michael Regnier


Vietnam Hospital for Tropical Diseases

Most clinical trials test new therapies against existing treatments in order to find out which approach is better at treating a particular illness. Carefully controlled and scientifically rigorous, this sort of experiment enables doctors to know which is the most effective and appropriate treatment for their patients.
In reality, medicine can be more complicated. If a patient comes to their doctor with more than one complaint, for example, should the doctor treat one disease at a time or both at the same time? The treatments for the two conditions may interact, causing more problems than they solve. Or the cumulative effect of both treatments may mean the patient is more likely to suffer toxic side-effects. But if the doctor postpones treatment for one illness while treating the other, the patient’s life may be put at risk.
This is frequently the case for people who have an HIV infection. HIV doesn’t always cause symptoms but it does make people more susceptible to other infections and illnesses. So in a lot of cases, HIV infection is detected only when the person goes to their doctor with symptoms of another serious – often life-threatening – illness, such as tuberculosis. Should the doctor treat the tuberculosis first or both infections at the same time?
Current guidance from the World Health Organization (WHO) suggests antiretroviral therapy (ART), the best treatment for HIV/AIDS, should not be delayed for the treatment of other conditions. This advice is based on observational studies but a number of trials have recently been set up specifically to test when is the best time to start treating HIV infection in people with a concurrent illness.


Poster raising awareness of HIV services in Vietnam

In Vietnam, a Wellcome Trust-funded trial examined the effect of delaying ART for patients who came to the Hospital for Tropical Diseases in Ho Chi Minh City with HIV-associated tuberculous meningitis. A tuberculosis infection in the central nervous system, this illness accounts for 25 per cent of global HIV/AIDS deaths.
Out of 253 such patients enrolled in the randomized controlled trial, 127 were given ART alongside their tuberculosis treatment as soon as they were diagnosed. The other 126 were given placebos instead of ART for two months, at which point they began to receive ART as their tuberculosis treatment continued.
Looking at the numbers of patients who died within nine months of starting treatment, the results, published last month in ‘Clinical Infectious Diseases’, showed no significant difference in mortality between those who had ART immediately and those who had two months of placebo. However, they did reveal that those who received ART immediately were more likely to suffer serious side-effects such as hepatitis and neurological effects such as seizures.
Based on this evidence, the study’s authors suggest ART should be delayed for two months in these patients. To do so seems not to affect their risk of dying, but it does reduce the chance of adverse side-effects.
Does this mean the WHO guidelines are wrong? Well, as a commentary article accompanying the research paper says: “The question of the optimum timing clearly has more than one right answer.” In Ho Chi Minh City, most of the patients with HIV-associated tuberculous meningitis are young, male intravenous drug users. As a group, they are more likely to have other complications such as hepatitis B and hepatitis C infections as well as HIV. This may be the reason why they are particularly susceptible to liver problems when treated with several drugs at the same time.
In this situation, then, it is likely that ART should be delayed to give patients the best chance of overcoming the tuberculosis infection before treatment for HIV begins. However, in other settings, as similar trials elsewhere are finding, it is better to give ART alongside treatments for other conditions as soon as possible, as per the WHO guidance.
The overriding message is that this is not a ‘one size fits all’ situation: different settings and different population groups require different approaches. Wherever they are in the world, doctors need to apply the art as well as the science of medicine.
http://wellcometrust.wordpress.com/2011/07/12/the-art-of-timing/#more-5838

POVERTY: EU to help Viet Nam reduce poverty

July, 02 2011

HA NOI — The European Delegation to Viet Nam yesterday announced that it had disbursed a total of 29 million euros (US$41million) in grants to support poverty reduction in Viet Nam.
Emmanuel Mersch, the EU's charge d'affaires, said that the disbursement corresponded with the EU Delegation's ongoing support of two development programmes in Viet Nam, both of which ended in 2010. Viet Nam's Socio Economic Development Plan (SEDP) in the period of 2006-10 received 17 million euros while the remaining 12 million euros went to support Programme 135 Phase II (period of 2006-10), which supported the socio-economic development of communes and villages in mountainous and ethnic minority areas.
According to Tran Thuy Dung, an official with the EU's collaboration and development committee who was directly involved with supporting peverty reduction programme 135, the delay of the disbursement was due to the unstable macroeconomy in Viet Nam last year which had not satisfied the EU donor's conditions for the grant. "Results from the International Monetary Fund released in the middle of June however showed that Viet Nam had recently carried out proper policies to stabilise the macroeconomy and efficiently control public finance management," she said.
The Poverty Reduction Support Credit (PRSC) is the general budget support mechanism used by all donors in Viet Nam. Under the PRSC, the EU and other development partners have been working with the Government to improve the content of important policies, particularly in the area of health, education, gender and public finance management, to ensure timely adoption of these policies and to monitor their impact on broader development objectives.
Disbursement of 17 million euros ( around $24.6million) takes account of the clear progress in policy reform made by the Vietnamese authorities in key areas, such as the introduction of internal audit legislation to improve public financial management, the establishment of national standards and a unified licensing system for health care practitioners, providing guiding legislation for the domestic violence law, and introducing a legal framework on consumer protection.
The remaining 12 million euros is the single instalment of the Raising the living standards of ethnic minorities in Vietnam, an agreement signed between the EU and Vietnamese Government in October last year.
Emmanuel Mersch said in the years to 2013, the EU Delegation was planning an additional 150 million euros ($212m) grant support to poverty reduction and the health sector. "However such budget support will only be possible if public financial management modernisation is steadily pursued and a stable macroeconomic environment is maintained," he added. — VNS
http://vietnamnews.vnagency.com.vn/Social-Isssues/212933/EU-to-help-Viet-Nam-reduce-poverty.html

MALNUTRITION: Vietnam: Ensuring micronutrients for mothers and babies

(VOV) May 28 2011 
Vietnam aims to reduce under-weight and malnutrition in children to below 10 percent, and stunted growth in children to less than 23 percent by 2015, announced Deputy Minister of Health Trinh Quan Huan.
The Ministry of Health held a ceremony in Hanoi on May 28 to launch the 2011 Micronutrient Day hoping to raise public awareness of essential nutrition and promote food hygiene and safety as well as Vitamin A and iron supplements for mothers and children.
The programme will be held nationwide on June 1-2 with a series of practical activities, including providing free Vitamin A supplements for children, education on micronutrients and consulting on food processing methods for pregnant women and babies.



Vietnam is facing malnutrition and a deficiency of micronutrients among children under five. The malnutrition rate for children under five is still high, at 17.5 percent, and more than 30 percent of them suffer from low weight and stunted growth.
In recent years, Vietnam has won praise from many international orgnisations because of the positive results of its malnutrition prevention programme.

http://english.vovnews.vn/Home/Ensuring-micronutrients-for-mothers-and-babies/20115/127011.vov

POVERTY: Poverty causes disasters and disasters cause poverty

09 May 2011  Sandra Bulling
As an international conference on disaster risk reduction gets underway in Geneva, CARE International warns that the increasing number of humanitarian disasters are eroding the coping ability of poor people and therefore undermining their ability to escape poverty. “Poverty causes disasters and disasters cause poverty,” says Robert Glasser, CARE’s Secretary General and one of the speakers at the Global Platform for Disaster Risk Reduction, May 8 – 13, 2011. “When disasters strike, poor people often lose their assets on which their survival depends. At the same time, their limited resources, lack of access to education and health services can increase their expose to risks. For example, many poor people’s livelihoods depend on agriculture. But a drought or flood can destroy a year’s income in the blink of an eye.”
In many regions, risk is growing. Population increase, climate change, increasing urbanization and environmental degradation are some of the drivers of future disaster risk for poor people worldwide. In recent decades, there has been a rise in both the number and impact of natural disasters. Developing countries are most exposed to the risks of disasters as their inhabitants often lack the ability to cope with or adapt to such events, especially in the case of re-occurring disasters. As more than half the world’s population lives in cities, poorly planned and managed urban development is a key driver of disaster risk. Poor housing, lack of health facilities and infrastructure put nearly one billion urban dwellers living in informal settlements at risk of disasters. The lives and livelihoods of people living in flood plains, low lying coastal areas and steep slopes are particularly in danger.
Deforestation, overgrazing and land degradation have damaged ecosystems and are exacerbating the risks of disasters such as floods or landslides. Very often, it is women who are most affected by disasters. More women than men are injured or killed during hurricanes and floods. They have in general less access to political and economic resources needed to protect themselves from disasters, and to deal with disaster effects. Women are less likely to know how to swim; they are often restricted from running fast by their clothing; their role as caretakers of children and older people as well as cultural rules restrict them from leaving their homes without the accompaniment of a male relative.
“We need to reduce the risks for poor people by strengthening their capabilities to cope with recurring disasters,” Glasser says. “One dollar invested in disaster risk reduction saves up to seven dollars in emergency response and rehabilitation.” This includes assisting people to diversify and adapt their livelihoods, helping build capacities of urban governance to ensure urban dwellers can live on safe lands and have access to infrastructure and services, and protecting ecosystems through community-based natural resource management.
CARE empowers local communities, especially women, to reduce their risk of disasters and strengthen their resilience. In Vietnam, for example, CARE assists communities in planting mangroves, which not only protect their villages from typhoons but have significant environmental benefits, including controlling erosion and nurturing fisheries. In India CARE constructed water supply points to withstand the effects of flooding, and to continue functioning during periods of inundation. In Peru CARE helped increase the capacity of communities to deal with extreme weather through capacity building, technical assistance and the development of pilot projects.
http://www.trust.org/alertnet/news/poverty-causes-disasters-and-disasters-cause-poverty/

MALNUTRITION: Viet Nam: 30 percent patients suffer malnutrition: survey

 23/04/2011

A recent survey, conducted in the last half of 2010, to record weight measurements and albumin levels of patients in Bach Mai hospital’s Intensive Care Unit (Hanoi), Cho Ray Hospital’s Department of Surgery (HCMC) and Can Tho Hospital, shows that 40-60% of the patients are underweight.
The Vietnamese have not given adequate attention to their nutritional needs during the treatment and recovery process, says Dr. Nguyen Gia Binh, head of Bach Mai’s Intensive Care Unit.

Little attention paid to nutritional needs
Dr. Binh points out that Vietnamese people often bring their own home-cooked food to the hospital for their family members, without being aware that the food may not be sufficiently nutritious for the patient.
It is essential that a hospital have nutritionists to advise patients on what to eat or how many calories to take in each meal.
“But we have yet to provide patients with nutritionists in Vietnamese hospitals,” says Binh.
To date, Bach Mai Hospital has set up a hundred diet regimens for different types of illnesses. These regimens and menus for certain typical diseases are posted on the canteen door for the patients’ reference.
These meals at Bach Mai hospital, provided on the recommendation of the hospital nutritionists, allow patients to choose what suits their taste and personal conditions.
However, Bach Mai is still a rare hospital that has its own nutrition center. In other hospitals, patients commonly eat food their relatives cooked and brought from home or buy unhygienic food from vendors outside the hospital.

Insurance should cover diet regimens, too
Dr. Dinh Thi Kim Lien, director of Bach Mai Hospital Nutrition Center, says patients with severe illnesses usually lose their appetite and do not want to eat, leading to weight loss and subsequently malnutrition.
“Malnutrition can retard the treatment and recovery progress,” she says.
“Eating much salty food can increase the blood pressure of hypertension patients. Kidney disease patients get worse if they are to eat food with high levels of protein,” Dr. Lien offers some examples.
Dr. Nguyen Quoc Tuan, head of the Planning Section of Bach Mai Hospital suggests that changing the patients’ awareness of the importance of food in medical treatment and recovery is the key factor to improving their nutrition intake.
The food not only has some influence on the illness but also interacts itself with the medicine given, says Dr. Tuan.
One common misconception among many cancer patients is that all the nutrients they get from the food will go to feed the tumors.
“Actually, cancer patients need to have sufficient nutrients to be able to undergo rigorous chemotherapeutic treatments. Patients with malnutrition cannot receive enough dosage of chemicals, bringing no improvement in their condition,” says Dr. Tuan.
Dr. Lien also suggests that the patients’ diet regime be considered as medicine and covered by insurance.
A standardized nutrient diet will cost a patient VND50-60,000 for 3 meals per day, while the money they have to pay for nutrition infusion is in the area of hundreds of thousands.
Since their insurance policy only covers nutrition infusion, a deplorable paradox arises where a patient healthy enough to eat is given nutrition infusion to help reduce the costs for the family.
For many poor patients unable afford anything other than porridge in their daily meal after an operation, recovery takes a long time due to malnutrition.
“And there are also a lot of patients who have nothing to eat but bread every day, for all their money have gone to pay for the hospital fees,” said Dr. Lien.
http://english.vietnamnet.vn/en/society/7443/30-percent-patients-suffer-malnutrition--survey.html

POVERTY: UK aid budget refocuses 'on areas of greatest need'

 Nicholas Watt, chief political correspondent guardian.co.uk,  27 February 2011
UK aid budget refocuses 'on areas of greatest need', including YemenEnd of aid to Russia, Serbia, China, Cambodia, Vietnam and Moldova, as poorer or failing nations prioritised

Britain is to stop sending aid to a series of relatively affluent developing countries as the government focuses resources on countries with the highest levels of poverty, and failing states that have become havens for Islamist fundamentalists.
A review of Britain's £8.4bn international development budget will herald the end of aid to Russia, Serbia, China, Cambodia, Vietnam and Moldova.
Aid to Yemen, regarded by Britain as a failing state whose lack of economic development provides a fertile recruiting ground for al-Qaida, will instead be doubled from £46.7m this year to £90m by 2015.
The changes will be announced by Andrew Mitchell, the international development secretary, who established separate reviews into Britain's bilateral and multilateral aid budgets after the general election.
The UN Educational, Scientific and Cultural Organisation (Unesco) could be a victim of the review of Britain's support for multilateral organisations. Unesco, which was boycotted by Britain for 12 years between 1985 and 1997 on the grounds that it was "pro-Soviet", will have to meet a series of targets to justify its aid after the review found that it wasted the £12m it receives from Britain each year.
Mitchell told the BBC Politics Show that the reviews would lead to Britain's aid budget being "much better focused" on areas of greatest need. "People who live in conflict states are very much part of that," he said.
The reviews are designed to answer opponents on the right and left who have criticised the government's approach to aid from different angles.
A focus on developing countries in greatest need, with a hard-headed payments by results system, is meant to show sceptical Tories that the aid budget is being spent in a sensible way. Many Tories believe it was wrong of David Cameron to ringfence the aid budget, after the prime minister pledged to maintain Britain's commitment to meet the UN target of spending 0.7% of gross national income on aid by 2013.
Targeting resources at a country such as Yemen, some of whose territory is used by al-Qaida as a training ground, is also designed to show that concerns on the left about the securitisation of Britain's aid budget are unfounded.
Charities have warned that aligning aid priorities with Britain's overall foreign and trade policy could lead to a return to the 1990s when the Pergau dam in Indonesia was funded with British aid money. Harriet Harman, the shadow international development secretary, voiced these fears when she warned of "subsuming aid activities into military activities".
Mitchell said it was in Britain's interests to help countries which present a threat. "It's very much in our national interest to tackle these effects of dysfunctionality and poverty, such as piracy, migration, terrorism and disease in Somalia," he told the Sunday Times. "Tackling the causes of poverty upstream is much less expensive than sending in troops."
Mitchell also tackled one of the main criticisms from the right, that it is wrong to provide aid to India, whose economy is growing at such a fast pace that Delhi can afford a space programme. "The fact is that if you want to reach these [UN] millennium development goals, which we are also keen to do by 2015, you have to operate where poverty is greatest," he told the Politics Show. "In India there are more poor people in three states than there are in the whole of sub-Saharan Africa. Operating there in the way that we do is extremely effective in poverty alleviation."

The reviews, which have been subject to independent peer review, will have four main themes:
• A complete overhaul of the way in which Britain distributes aid. Mitchell believes that Gordon Brown announced an overall figure for a grant to a particular country without working out what exactly that would deliver. "Now it is going to be payment by results, so money will only be granted if it is clear how many more children will be educated in a given country and how much clean water will be supplied, for example," one source said.
• Independent evaluation. A four-strong independent panel, including the Kenyan anti-corruption expert John Githongo, will monitor aid spending. The panel will report to parliament.
• Britain has a moral duty to help those in need in line with its values. Mitchell frequently quotes the anti-slavery campaigner William Wilberforce to support the aid cause. "You may choose to look the other way but you can never say again you did not know," Wilberforce said.
• It is in Britain's own national interests to help countries which present a threat, however indirectly.
http://www.guardian.co.uk/global-development/2011/feb/27/uk-aid-budget-andrew-mitchell

POVERTY: LAOS: Decision expected on controversial Mekong dam

25 February 2011 (IRIN)

 Photo: Tharum Bun/IRIN : Experts and activists predict tough times ahead for Mekong River communities

BANGKOK, - The proposed Xayabury Dam on the lower Mekong River promises to supply much-needed energy to the region, but at a "devastating" environmental and personal cost to surrounding communities, say activists and environmental experts.
"Millions more people in the region are likely to be adversely [affected] through changes to the river's biodiversity, fisheries and sediment flows," said Ame Trandem with International Rivers, a US-based environmental NGO.
The dam's main developer is Thai construction company Ch Karnchang.
Sixty-five million people depend on the Mekong River - the largest inland fishery in the world - for survival and its biodiversity is second only to the Amazon in South America, according to Jeremy Bird, director of the Laos-based Mekong River Commission (MRC), a regional intergovernmental advisory body on any mainstream development conducted on the river.
More than 200,000 fishermen and farmers - most of the lower riverside community - will suffer displacement and reduced earnings if the Xayabury Dam is built in Laos, states International Rivers.
Based on the 2010 Strategic Environmental Assessment (SEA) commissioned by MRC, "dam construction will result in irreversible environmental impacts", said MRC spokeswoman Tiffany Hacker.
Damage to fisheries "cannot be mitigated by fish passes and reservoirs", said Alan Brooks, director of the Phnom Penh-based NGO, World Fish Center.
The dam is the first of 11 hydropower dams proposed along the lower Mekong River. Though a regional agreement requires prior consultation with MRC before a project can move forward, there is no way to enforce this recommendation.
The Mekong Agreement, which recognizes the shared impacts of river development projects on neighbouring countries, stipulates that Thailand, Cambodia, Laos, and Vietnam must all approve major projects on the lower Mekong River.
The four governments may announce their positions on the dam by as early as March 2011, according to International Rivers.
"What happens with the Xayaburi Dam will essentially set the precedent for whether more mainstream dams are built or not, many of which will [have] devastating impacts on the region's people in terms of lost income, livelihood and food security," said Trandem.
http://www.irinnews.org/report.aspx?ReportID=92037

POVERTY: VIETNAM: Struggling to cope with rising prices

1 March 2011 (IRIN)


Photo: David Gough/IRIN: Eight out of 10 people in Vietnam live in rural areas,which like the rest of the nation, is hit with record price increases

HO CHI MINH CITY,  - Vietnam's inflation rate is among Southeast Asia's highest and its population is struggling to keep up with sharp increases in food, fuel and electricity prices.
On 1 March the government increased electricity prices by a record 15 percent to an average 1,242 dong (US 6 cents) per kilowatt per hour. The week before, petrol prices were raised by 18 percent to 19,300 dong (93 cents) per litre.
In Vietnam, inflation has increased every month since August 2010, reaching 12.2 percent in January.
"Things are getting really uncertain," said Nguyen Bich Hanh, 25, a public school teacher who lives on the outskirts of the capital, Ho Chi Minh City. "We are struggling to pay for electricity, and food [prices are] getting extreme."
In the past two months, Nguyen said the price of high-quality rice, for example, had increased by almost one-third to 22,000 dong ($1.13) per kilogramme.
She earns $150 a month and spends most of it on food and transportation for her family of five.
The World Bank ranks Vietnam as a lower middle-income country. Still, worries about poverty run deep in a country where 80 percent of the population lives in rural areas and most of the workforce is agricultural.
Half the population lives on less than $2 a day, and many could slide into poverty because of economic shocks and natural disasters, according to AusAID, the Australian government's aid agency.
Nguyen saves money by turning off the electricity at home at all times, and increasingly, by skipping meals.
"Fewer kids are coming to school because they need to help their families," she said.

Coping
Sudden price fluctuations are forcing Vietnam's poorest to find quick and creative ways of coping, said Ben Kerkvliet, a Vietnam scholar at the Canberra-based Australian National University.
"Many rural households in Vietnam have small gardens, small fish ponds or other aqua-raising opportunities, chickens or ducks... that help to feed their families," he told IRIN. "In hard times, these sources of food become even more important.
"Youngsters in the household may go to school without school supplies. They may have to quit school altogether," he added. So far, Vietnam has performed well in enrolling students in primary school and keeping them there.
In 2009, net enrolment in primary school was 97 percent and 88.5 percent of children who enter primary school complete at least five years, according to the UN office in Vietnam.
But should inflation increase sharply beyond current levels, said Kerkvliet, general stability could slide. "Should shortages of key commodities like rice and wheat become extreme, villagers are likely to protest in various parts of the country," he said. "At present levels of inflation, the likely political change will be policies aimed at addressing the problems."
This year, the government hopes to limit inflation to 7 percent, compared with 11.75 percent last year.
For Nguyen, poverty is more pressing than numbers on paper. "They say our country is becoming richer," she said, "but this does not matter if regular people cannot afford anything."
http://www.irinnews.org/report.aspx?ReportID=92058

POVERTY: A much ignored strategy for reducing poverty?

By Dr. Rolando T. Dy, Executive Director Center for Food and Agri Business
The Philippine Star: January 16, 2011

MANILA, Philippines – Tree-crops have played a key role in the development of agriculture and poverty reduction in many ASEAN countries. (I can attest to this as an agricultural project economist in Malaysia in the late 1970s and early 1980s).
Let’s compare the achievements of these countries in the past three decades in tree crop development. Specifically, this involves area harvested, production and export. Let’s also discuss the possible impact on poverty reduction and the key success factors.
The ASEAN countries are key players in the global market for tree-crops: palm oil, rubber, coffee, cacao, coconut, and cashew.
• Indonesia, Malaysia and Thailand in that order are the world’s largest producers of palm oil; the first two control some 90 percent of the world’s exports.
• Thailand, Indonesia, Malaysia and Vietnam control most of the rubber exports.
• Vietnam ranks second in the world in coffee production and exports. Indonesia is fourth.
• Indonesia is among the top cocoa exporters.
• Indonesia and the Philippines are the top producers of coconut while the latter is the top exporter of coconut oil.
• Vietnam is the world’s leading cashew exporter.

Area expansion
Tree-crops harvested areas in Indonesia expanded 3.1-fold to 13.1 million hectares during 1980-2008, Malaysia 1.9 times, Thailand 1.7 times, and Vietnam 9.7 times. By contrast, the Philippines had its areas expanded less than 1.1 times.
Production expanded faster because of an increase in productivity, particularly oil palm in Indonesia, rubber in Thailand, and coffee and cashew in Vietnam. The Philippines was heavily dragged down by lack of progress in coconut replanting and fertilization.
Exports
Total exports expanded 13-fold in Indonesia to $22.8 billion in 2008, five in Malaysia to $17.2 billion, 12 in Thailand to $7.3 billion, and 74 in Vietnam to $2.4 billion from 1980. Meanwhile, Philippine exports moved up only 1.6 times to $1.1 billion.
During the past three decades from 1980, the ASEAN countries – particularly Indonesia, Malaysia, Thailand and Vietnam – were game changers in the world of tree-crops. They collectively captured market shares from the rest of the world to ASEAN.
In 1980, ASEAN controlled 63 percent of the world exports of palm oil and this jumped to 87 percent in 2008. For coffee, market shares rose from seven percent to 24 percent while cacao beans from three percent to 14 percent. For cashew, ASEAN market share dramatically expanded from two percent to 20 percent.

These successes can be attributed to four countries: Indonesia, Malaysia, Thailand and Vietnam.
Country analysis
Indonesia. The tree-crop drivers were: palm oil, rubber, and cocoa. It is now the world’s leading palm oil producer/exporter, and the world’s second largest rubber producer after Thailand. The main achievements were:
• Oil palm harvested areas skyrocketed to five million hectares in 2008 from only 204,000 hectares in 1980. In fact, if immature areas were counted, there were seven million hectares planted in 2008.
• Rubber areas rose to 2.9 million hectares from 1.6 million hectares in the same period.
• Cocoa areas shot up to 990,000 hectares from 19,000 hectares.
• Coffee areas increased to 977,000 hectares from 498,000 hectares.
Malaysia has been a tree-crops country for many years. It was the world’s largest palm oil producer until it was surpassed by Indonesia in 2005. In a similar vein, it was also the world’s largest natural rubber producer until overtaken by Thailand in 1985. The shift from rubber to oil palm was due to higher labor costs and better farm profits while the slowdown in oil palm expansion was limited by land. Thus, Malaysian firms, like Sime Darby, expanded into Indonesia.
• Harvested areas of oil palm grew to 3.9 million hectares in 2008 from 777,000 hectares in 1980. A large part of these are in Sabah and Sarawak.
• By contrast, rubber areas declined to 1.2 million hectares from 1.6 million hectares in the same period.
Thailand. The main drivers of growth were palm oil and rubber. Thailand is the third largest palm oil producer after Indonesia and Malaysia, and the biggest producer/exporter of natural rubber.
• Oil palm harvested areas rose to 462,000 hectares in 2008 from only 11,000 hectares in 1980.
• Rubber areas expanded to 1.8 million hectares from 1.2 million hectares. The high production was driven by higher farm yield.
Vietnam provides an outstanding example of tree-crop development. From negligible exports in 1980, it expanded to $2.4 billion in 2008. The leading drivers were coffee, cashew and rubber. The country posted dramatic changes since the end of the Vietnam War in 1975. Among the highlights are:
• Expansion of rubber harvested areas to 632,000 hectares in 2008 from only 88,000 hectares in 1908.
• Massive increases in areas to 531,000 hectares from 33,000 hectares during the same period
• Explosive growth of cashew areas to 403,000 hectares from 8,000 hectares in the same period.
Philippines. Where is the Philippines in the picture? It failed in many respects. Despite its natural endowments for tree-crops, the country has less than 300,000 hectares over 30 years as compared to millions of hectares by its more dynamic neighbors.
• Oil palm harvested areas grew to only 22,000 hectares in 2008 from 6,000 hectares in 1980, despite large potentials in Mindanao and Palawan.
• Rubber areas expanded to 123,000 hectares from 54,000 hectares in the same period (although the author doubts the figures). Compare this with experts’ estimate of the potential of at least 500,000 hectares.
• Coffee areas grew to123,000 hectares from 102,000 hectares in the same period. While the areas grew, many are senile and unproductive.
• Coconut areas, the largest of all, increased to 3.4 million hectares in 2008 from 3.2 million hectares in 1980, or a gain of only 144,000 hectares! Given that over one million hectares are senile, this is not a major movement.
http://www.philstar.com/Article.aspx?articleId=648446&publicationSubCategoryId=77

MALARIA: Malaria transmission and vector behaviour in a forested malaria focus in central Vietnam and the implications for vector control

Wim Van Bortel et al. Malaria Journal 2010, 9:373 Published: 23 December 2010
Background
In Vietnam, malaria is becoming progressively restricted to specific foci where human and vector characteristics alter the known malaria epidemiology, urging for alternative or adapted control strategies. Long-lasting insecticidal hammocks (LLIH) were designed and introduced in Ninh Thuan province, south-central Vietnam, to control malaria in the specific context of forest malaria. An entomological study in this specific forested environment was conducted to assess the behavioural patterns of forest and village vectors and to assess the spatio-temporal risk factors of malaria transmission in the province.

Methods
Five entomological surveys were conducted in three villages in Ma Noi commune and in five villages in Phuoc Binh commune in Ninh Thuan Province, south-central Vietnam. Collections were made inside the village, at the plot near the slash-and-burn fields in the forest and on the way to the forest. All collected mosquito species were subjected to enzyme-linked immunosorbent assay (ELISA) to detect Plasmodium in the head-thoracic portion of individual mosquitoes after morphological identification. Collection data were analysed by use of correspondence and multivariate analyses.
Results
The mosquito density in the study area was low with on average 3.7 anopheline bites per man-night and 17.4 culicine bites per man-night. Plasmodium-infected mosquitoes were only found in the forest and on the way to the forest. Malaria transmission in the forested malaria foci was spread over the entire night, from dusk to dawn, but was most intense in the early evening as nine of the 13 Plasmodium positive bites occurred before 21H. The annual entomological inoculation rate of Plasmodium falciparum was 2.2 infective bites per person-year to which Anopheles dirus s.s. and Anopheles minimus s.s. contributed. The Plasmodium vivax annual entomological inoculation rate was 2.5 infective bites per person-year with Anopheles sawadwongporni, Anopheles dirus s.s. and Anopheles pampanai as vectors.
Conclusion
The vector behaviour and spatio-temporal patterns of malaria transmission in Southeast Asia impose new challenges when changing objectives from control to elimination of malaria and make it necessary to focus not only on the known main vector species. Moreover, effective tools to prevent malaria transmission in the early evening and in the early morning, when the treated bed net cannot be used, need to be developed.
http://www.malariajournal.com/content/9/1/373

POVERTY: HCM City (Saigon) poverty rate exceeds Ha Noi

Dec 16, 2010

HA NOI — There are far more poor people in HCM City than in Ha Noi when a multi-dimensional poverty approach is adopted, despite higher average incomes in the southern city.
The 2009 Urban Poverty Survey, which was launched in Ha Noi yesterday, showed a higher poverty rate in HCM City in seven out of eight measures of poverty, including social welfare, education, health, housing, housing area and quality, participation in social activities and security.
However, if the traditional way to measure poverty, based on income is adopted, the poverty rate in (prior to expansion) Ha Noi in 2009 was higher than in HCM City on all benchmarks.
The capital had 1.27 per cent of its population living under the 2006 national income poverty line (about US$1 per day), compared to 0.31 per cent in the southern city.
The figure increased to 1.34 per cent and 4.57 per cent for international standards of $1.25 and $2 per day in Ha Noi, much higher than 0.29 per cent and 2.08 per cent in HCM City.
Although a small part of the population in the two biggest cities were living below the poverty line, more than one-third of the population in both places had no access to social security networks and were living in low quality, cramped dwellings, the survey found.
A higher proportion of people in HCM City were living in overcrowded living conditions - defined as less than 7 square metres per person - than in Ha Noi (31 per cent versus 26 per cent).
While 9.8 per cent of Ha Noi's population did not go to junior-secondary school, almost 27 per cent of HCM City population were in this category. Similarly, more than one in every five people in Ha Noi had a university degree while the rate was only one in 10 in HCM City.
More than seven in every 10 people living in Ha Noi had some forms of health insurance, a sharp difference with nearly six in 10 in HCM City.
There were significant differences between the two cities in terms of employment, the survey found.
University degree-holding workers in Ha Noi almost doubled those in HCM City; and compared to the southern city, twice as high the proportion of workers in the capital had permanent work contracts, which meant more work-related benefits.
The multi-dimensional poverty indices also revealed inequalities between rural and urban areas, and unregistered or temporary migrants compared to permanent residents in both cities.
For instance, a majority of migrants (62 per cent) were living in cramped space, a sharp contrast with the registered resident population of both cities (17 per cent).
"The results clearly show that while Ha Noi and HCM City have enjoyed tremendous economic growth, this has not benefited everyone living in the two cities," said UNDP country director Setsuko Yamazaki.
So the research clearly pointed to the fact that both cities were facing challenges in ensuring sustainable and equal economic and social development, she said.
The survey, conducted in October and November last year with the participation of more than 8,200 people, was the only source of information on poverty and living conditions among migrants in Viet Nam's two biggest cities, said Ha Noi People's Committee deputy chairman Hoang Manh Hien.
"This is the first time a project has adopted a multi-dimensional study of poverty in Ha Noi and HCM City," he said.
UNDP expert Nguyen Bui Linh said the income/expenditure approach to assess poverty had major limitations as income was not the only determining factor in assessing standards of living.
The Urban Poverty Survey was conducted by the General Statistics Office and the two municipal People's Committees with the support of the UNDP. — VNS
http://www.dztimes.net/post/social/hcm-city-s-poverty-rate-exceeds-ha-noi-despite-higher-incomes.aspx

POVERTY: NEPAL: Land tenure reforms "urgently needed"

  Photo: Kate Holt/IRIN:  A woman from Rupandehi in Nepal's Terai region, which has a high concentration of landless tenant farmers

KATHMANDU, 8 December 2010 (IRIN) - "Drastic" land reforms that give more rights to poor families who labour on others' land are needed in Nepal to stave off hunger among the poorest and boost agricultural production, say analysts.
"No matter what technology you bring, agricultural problems will always persist if we don't address the land reform issue seriously," said Bishnu Upreti, from the South Asia office of the international NGO, Swiss National Centre of Competence in Research North-South (NCCR).
He added that a culture of feudalism, poorly enforced land distribution and an informal caste system have exploited landless tenants. The problem is most apparent in the Terai region below the Himalayas, populated mostly by Dalits, one of Nepal's poorest ethnic groups.

Landless in Terai
According to the most recent government census 1.3 million out of 4.2 million families in Nepal did not own land in 2001. With an estimated four members per family, the estimated landless population was 5.5 million people - out of a population of 21 million, or 26 percent - mostly members of the Dalit and other Terai communities.
According to local NGO Dalit Welfare Organization, 15 percent of Dalits living in the western hills of Nepal and 44 percent of those in Terai were landless, out of six million Dalits nationwide in 2009.
Almost all these families depend on agriculture for their livelihoods and there is an "urgent" need to reform land laws, said Kailash Pyakhurel with the local NGO Consortium for Land Research and Policy Dialogue (COLARP) .
Small farmers, tenants, sharecroppers, and landless workers are the most vulnerable to hunger and poverty, according to COLARP. "The cost of not having land reform is very high. The agricultural productivity is not increasing," said Pyakhurel.
Until now most land decisions have been made on an ad-hoc basis with no registration, he added.
The country's first Land Act was introduced in 1964. Even after six rounds of amendments, it continues to favour landlords and does little to protect the rights of tenants, said Pyakhurel.
There is a need to replace the current land tenure system with one that constitutionally guarantees land reform - and gives the traditionally landless a chance to own the land they work; land management continues to remain highly centralized and even local government has little power to change the system, noted COLARP.
Failed distribution
Since the introduction of a land tenure system in Nepal in 1951, laws have afforded tenants scant protection other than for those with money, according to a 2009 study funded by the UK Department for International Development (DFID).
Under current land codes, tenant farmers should be able to purchase land they cultivate through cash and collateral, but owners have been able to thwart the system to hang on to land, wrote the author's report, Liz Alden Wily, a land tenure specialist based in Nairobi.
"This is not an experience unique to Nepal; although there have been successes, on the whole redistributive farmland reform has failed [in Nepal]," she said.

Successful redistribution could change the decades-old dynamics of land ownership.
"The most important difference it makes is to shift landless tenants and workers into a situation where they are shareholders in the farming economy, not just casual pawns or beneficiaries," explained Wily.
China, Vietnam, Taiwan and South Korea have undertaken successful land reforms in Asia, she noted, and change is overdue in Nepal. "This is an insult to the tenants and workers who have been working the same land for decades," Wily concluded.
According to the local NGO,Federation of Nepal, most of the country's land is controlled by the Nepalese elite. As absentee landlords, most do not even live in the villages where they legally own land, yet they reap most of the income.
With no legal claim to the land, or registration that even recognizes them as tenant farmers, instead of receiving a 50 percent share of the harvest, labourers get at most one-third and, more often, one-tenth of earnings.
http://www.irinnews.org/report.aspx?ReportID=91313

POVERTY: Viet Nam targets 5% poverty rate by 2020

December, 01 2010

  VNA/VNS Photo Dinh Hue
A household in the northern province of Bac Giang's Luc Nam District was named an excellent production farmer family.

HA NOI — Viet Nam aims to reduce the poverty rate to five per cent or less by the beginning of the next decade from the current estimated rate of 9.45 per cent under a draft resolution on directing sustainable poverty reduction during the 2011-20 period.
Drafted by the Ministry of Labour, Invalids and Social Affairs, the resolution is expected to be approved by the Prime Minister later this year.
"The resolution also targets stable employment and diversified income generation activities for poor labourers and seeks to increase per capita income in poor families by 3-3.5 times by 2020," said Deputy Minister Nguyen Trong Dam yesterday at an information sharing and consultation workshop on the resolution.
When finalised, the resolution is expected to guarantee basic conditions for housing, clean water and access to health care, education, vocational training and legal assistance. It will also ensure economic resources such as funds, land, technology and markets, as well as quality infrastructure for production and living practices in poor districts and communes, particularly those in remote, mountainous and particularly-difficult areas.
"Priority will be given to ethnic minority people, women, children, old people and the disabled," he said.
Major policies for poor people include policies that provide preferential credit, free and employment-oriented vocational training, free agricultural-forestry-fishery extension services, fee exemptions and reductions for education, and other support for poor people.
Funds will also be allocated to upgrade medical infrastructure to guarantee basic health services to poor people and suitable interventions will be designed to mobilise and use social resources and the State budget for poor patients suffering fatal diseases. The funds will support medical costs and meals when patients are moved for higher levels of treatment.
Policies on housing and clean water, legal support for poor people and accessibility to cultural and information services are also included in the draft.
Deputy Director of the ministry's Social Sponsor Department Ngo Truong Thi said the resolution was needed because although significant achievements in poverty reduction have been reached and recognised by the international community, the results were still not really sustainable.
"The gap between rich and poor is increasing and the poverty rate in many localities remains high," he said.
Many limitations remained to the implementation of poverty reduction objectives, such as overlaps, disconnection and inconsistencies between policy mechanisms and resources. These were combined with challenges in reaching poverty reduction objectives such as the risks that come with international integration, impacts of climate change and mid-income pitfalls, he said.
To perfect the resolution, Le Thi Thanh Huyen from the United Nations Population Fund in Viet Nam said the resolution should also target other vulnerable groups such as HIV/AIDS patients and people with disabilities.
Cross-cutting issues such as the development of transport and communication systems, and infrastructure in remote and mountainous areas should also be included and linked with the poverty reduction programme, she said.
For example, how could poor farmers sell the items they produced thanks to Government support programmes without infrastructure development, she said.
"It is also essential to effectively co-ordinate poverty reduction programmes with other similar programmes to ensure sustainable and comprehensive results," she said.
She also suggested more specific policies for ethnic minority people such as mobile healthcare services as they have difficulty accessing basic social services as a result of language barriers and transport conditions.
A representative from the United Nations Children's Fund in Viet Nam, Nguyen Thi Van Anh, pointed out the need for the resolution to include more policies to support children under six years old, such as policies to improve health care, education and curb malnutrition to help improve their quality of life.
Viet Nam was one of among 39 countries ranked with a high stunted growth rate, and the poor accounted for a large part of this number, she said.
Nguyen Thi Thu Thuy from Caritas Switzerland, which provides emergency disaster relief and co-operates with partners around the globe to implement reconstruction projects and promote sustainable development, said the resolution has yet to clearly map out measures to ensure the sustainability of poverty reduction.
It was essential to not only create jobs for the poor but it was even more important to ensure sustainable poverty reduction, she said.
She also pointed to the need to train poverty reduction programme officials in different ways in order to gain access to different types of poor people to avoid misunderstandings and complexities, as the poor came from different cultural and social characteristics.
There are around 3.3 million poor people nationwide, according to the ministry. — VNS
http://vietnamnews.vnagency.com.vn/Economy/206249/Nation-targets-5-poverty-rate-by-2020.html

MALNUTRITION: Viet Nam tries to reduce stunting malnutrition

Nov 12, 2010 Viet Nam is facing challenges in its annual goals to reduce the rate of malnutrition among children under five years old from 30 per cent to 2 per cent by the year 2020.
Nutritionists met in Ha Noi yesterday and said the target - which is a crucial element to improving the height of Vietnamese people - would be hard to reach in the next decade despite the good results that have already been achieved.
Ministry of Health statistics show that the rate of malnutrition, which leads to stunted growth, fell from nearly 60 per cent in 1985 to 47 per cent in 1994 and 31.9 in 2009.
The percentage of children under five who are underweight due to malnutrition reduced from 51.5 per cent in 1985 to 18.9 per cent in 2009. Studies have shown an average height increase of 1-2 centimetres in Vietnamese children and adults in recent decades, according to the National Institute of Nutrition (NIN). "By analysing factors that contribute to malnutrition in children, we can reduce the current numbers. However, the speed of reduction will be slower than the rate in the 90s," said Deputy Director of NIN Le Danh Tuyen.
Mothers needed to get proper nutrition prior and throughout their pregnancies, he said. They also needed to provide their growing children with proper nutrition, especially before they reach the age of five as children under five need sufficient energy and nutrition to grow properly.
"In order to firmly reduce stunted growth due to malnutrition, comprehensive improvement in providing food to families, health care services and environmental and care taking activities are needed. Emphasis has been put on caring for the quality of nutrition, particularly at the family level," said Tuyen.
Malnutrition prevention activities should be socialised in all corners of the country with a specific policy designed for each region. Areas that are threatened by the risk of food insecurity should develop measures to ensure sustained provision of food. Production activities and self-sustaining food production are encouraged along with a strengthening of nutrition communication activities.
http://www.dztimes.net/post/social/nation-tries-to-reduce-stunting-malnutrition.aspx

SANITATION: VIETNAM: Teaching new sanitation habits

Photo: Tharum Bun/IRIN

Water and sanitation challenges continue in VietnamCHAU DOC, 28 October 2010 (IRIN) - Vann Sopheap, an ethnic Cambodian who lives in this small border town in Vietnam, prefers the outdoors to the bathroom. "It smells much nicer outside," he says. "The toilets are too dirty."
Villagers such as Vann are often reluctant to use latrines, a behaviour that contributes to the prevalence of diarrhoeal diseases in Vietnam, which can sometimes become deadly, especially for children under-five.
According to the UN, some 10 million people in Vietnam continue to practise open defecation.
Each year more than 20,000 people die in the country because of a lack of clean water, poor sanitation and hygiene, the World Health Organization (WHO) reports.
Sanitation lags behind other MDGs
In the past two decades, speedy economic growth and efficient government policies have led to "considerable gains" in child health, Lotta Sylwander, the country representative for the UN Children's Fund (UNICEF), recently told government officials and international donors in the capital, Hanoi.
The country has achieved almost all the Millennium Development Goals (MDGs) "well ahead of schedule", making it a leader among many Asian countries, reveals a report published by UNICEF in September. But progress in sanitation has been slow.
In 2006, the latest year for which data is available, just over half of the rural population had access to "improved" sanitation facilities, as did 88 percent of the urban population, according to UNICEF.
Twenty million children, or 59 percent of all children in Vietnam, do not have access to proper sanitation. About 73 percent of schools have latrines, but fewer than half meet national standards. A lack of access to clean sanitation and hygiene causes about half of all communicable diseases in the country.
"Poverty can be one reason for this, but education and culture play very important roles as well," Thowai Zai, head of the UNICEF water and sanitation programme, told IRIN.
Many people living in rural and remote mountainous areas consider open defecation to be cleaner, he said. In poor areas, especially in northern mountainous regions and the central highlands, people have much scarcer access to toilets, Zai added.
Others defecate in rivers and ponds, the same water sources they use for cooking, cleaning and bathing.
Some experts argue that NGOs need to more effectively educate villagers. "Villagers know it's no good to poop into the water," Jack Sim, founder of the World Toilet Organisation, told IRIN from Singapore.
"The only thing needed is to reinforce that message, because old habits take time to change," he added.
Community approach
Merely providing toilets does not guarantee local people will use them, experts say.
To encourage more efficient use of latrines and good hygiene, in 2009 the Ministry of Health introduced a programme called community-led total sanitation (CLTS), in several poor provinces throughout the country, such as Dien Bien, Lao Cai, Kon Tum, Ninh Thuan, and An Giang.
Rather than NGOs subsidizing the construction of individual toilets for each household, the project attempts to mobilize communities to analyze their own sanitation problems and agree on their own solutions.
UNICEF hopes the villages can become "open-defecation-free".
Earlier this year, the Asian Development Bank (ADB) approved a US$45 million loan for a large water supply and sanitation project in six central Vietnamese provinces.
The loan will be used to improve toilets in schools, hospitals and homes. About 350,000 people will reap the benefits, according to the ADB, which hopes the project will be completed by 2016.
http://www.irinnews.org/report.aspx?ReportID=90900

MALNUTRITION: Vietnam meets hunger MDG ahead of 2015

14 September 2010 (IRIN) -
A new Oxfam report highlights Vietnam's performance in meeting the UN Millennium Development Goal of halving hunger and reducing poverty five years ahead of the 2015 target. "Vietnam's track record is one of the best in the world. They are absolutely a role model within East Asia and more broadly in the world," Steve Price-Thomas, Oxfam's Vietnam country director told IRIN on 14 September from Hanoi.
According to Halving world Hunger: Still Possible [ http://www.divshare.com/direct/12507579-6ba.pdf ], Vietnam has cut hunger and reduced poverty from about 58 percent of the population in 1993 to just 18 percent today. "To put this in perspective, this means that since 1993 roughly 6,000 people per day have been pulled out of hunger poverty," Price-Thomas said. By focusing on agricultural land reform, Vietnam has made land distribution more equitable, invested heavily in irrigation and agricultural technology and maintained restrictions on rice exports until 2001, nurturing the domestic industry. The UN Food and Agriculture Organization is set to announce on 14 September that the number of hungry people worldwide has dropped, for the first time in 15 years, from 1.23 billion in 2009 to 925 million. [ http://www.fao.org/world/regional/rap/news.asp ].
Http://www.irinnews.org/report.aspx?ReportID=90468

POVERTY: Reducing Global Poverty - Back to the Future?

Michael Edwards,
10 September 2010
Ten Years of War on Poverty, 2010
When I was a PhD student in the late 1970s I was taught that there was no one route to poverty-reduction, but that since some countries had already reduced poverty pretty well we should learn from their experience. Not exactly rocket science is it?
The so-called East Asian Tigers, mirrored by Brazil, Botswana, China, Vietnam and a few others in more recent years, tackled their development problems through a combination of strategic direction by their governments, a gradual expansion and opening of their economies to world trade, heavy investments in health and education (as universal as resources would allow), and social contracts between different sectors of society that were strong enough to keep these processes moving forward. The role of international assistance was simply to support these self-directed efforts by helping to fill temporary gaps in resources and protect them from the destabilizing effects of international economic and other shocks.
Listening to the presentations on day three of the Manchester conference, I have a distinct sense of déjà-vu, since all of them seem to be rejecting the bureaucracy and technocracy that have come to dominate the international poverty-reduction industry in the last twenty years. Rather than fancy innovations, I’m hearing a continual re-affirmation of an older set of ideas and (since one can’t afford to be too romantic about the past), a debate about the unfinished agendas they reveal. Take, for example, a new report from UNRISD in Geneva that was discussed last night, entitled “Combating Poverty and Inequality: Structural Change, Policy and Politics,” or “how to transform world capitalism” in shorthand as UNRISD’s excellent new director, Sarah Cook, confided to me later in the conference bar. Citing the need to re-distribute resources so that poverty and inequality are attacked together, institutionalize human rights in every area of life, and focus on the quality of economic growth and employment and not just the amounts of these things, it’s a report that draws heavily from recent history but that also re-surfaces some deeper questions about what the “East Asian Miracle” left out.
Notable omissions include the environment, addressing social violence, and – in one of the few conference presentations to take a gendered perspective – the issue of “who cares,” which Naila Kabeer from SOAS raised in her response to the UNRISD report. Citing evidence from India and South Africa, Kabeer explained why increasing women’s paid employment may not result in poverty-reduction, in part because their unpaid work is not factored into the equation, an issue of enormous social significance that has all-but disappeared from the official poverty-reduction debate and is nowhere to be seen in the UN Millennium Development Goals. Given the deep inequalities and injustices created by this omission, one might have thought that they would be front and center in any attempt to reduce poverty and discrimination.
The avuncular Angus Deaton from Princeton University continued the conversation by shredding the credibility of income-based measures of poverty – another old debate that is re-surfacing in the conference with a vengeance. The dapper Deaton (wearing the only bow tie witnessed since Wednesday), achieved the considerable feat of weaving ‘Purchasing Power Parity’ and its limitations into an entertaining presentation. International poverty statistics, he concluded, are basically meaningless (“nonsense on stilts”), because there are no shared consumption patterns between countries on which to base a rigorous comparison. So, “how about we replace all the experts and just ask people how their lives are going?” Even the experts themselves laughed and clapped at that one, which I thought was commendably un-self-interested. The serious point is that such measures are dangerous when applied in practice, and should be replaced by indicators of “multi-dimensional” poverty such as those that have been developed by Sabina Alkire from Oxford University, who was one of the respondents to Deaton’s presentation. UNDP are already using them to improve their next Human Development Index, soon to be released.
In all these respects, maybe the conference has been miss-named. It isn’t so much “what we have learned about poverty” but what we have forgotten that really matters, and what we need to remember, reaffirm, and re-interpret in the different contexts and conditions of today. Poverty-reduction is not a technocratic exercise for billionaires and bureaucrats but an exercise in human solidarity that aims to liberate all of us from conditions of oppression. But what kind of international machinery could possibly encourage such a thing?

Michael Edwards is a Distinguished Senior Fellow at Demos: A Network for Ideas and Action, in New York, and the author of Small Change: Why Business Won't Save the World. He was formerly a director at the Ford Foundation. His website is www.futurepositive.org
http://www.opendemocracy.net/michael-edwards/reducing-global-poverty-back-to-future