Final report EVALUATION OF CORDAID S FLOOD RESPONSE 2010 PROGRAMME PAKISTAN December 2011 Ton de Klerk Shahida Sultan
Executive Summary In late July 2010, heavy monsoon rains caused severe flash floods in the northern mountain regions of Pakistan. Next the floodwater waves washed down from north to south submerging in the next two months at one point a fifth of the country s land mass. Early August 2010, the Aid Agencies in the Netherlands (SHO) started a joint fund raising campaign for an emergency response to the Floods in Pakistan. Total donations amounted to 27.5 million, of which Cordaid received approx. 5 million. Cordaid was implementing a health programme in Shangla District, in the North-Western part of Pakistan. The district was severely affected by the monsoon rains. The health team responded immediately, providing medical assistance and assuring medicines supplies in the worst affected areas. A first rapid need assessment was conducted in early August identifying the fields in which emergency response was needed: shelter, NFI s, WASH and Health. On the basis of this assessment it was decided by Cordaid to scale up its programme in Shangla, focusing on shelter, WASH and Health. Later on it was decided to start-up a shelter rehabilitation programme in Kohat. In Shangla and Kohat districts Cordaid implemented the programme itself (budget: approx. 3,25 million). CRS received additional funding for its shelter programme in Shangla, Kohistan and Swat districts for the construction of latrines, to complement the budget of other donors (budget: 458.655). Cordaid cofunded the CRS Emergency Response programme in Sindh (budget: 1.592.894). In Punjab, two local partner organisations of Mensen met een Missie, one of the constitutional member organisations of Cordaid, received funding for an early emergency response (total budget: 173.707). The main purpose of the evaluation study was to measure the performance of Cordaid in the 2010 Flood Response Programme, looking at the overall performance of Cordaid HQ, Cordaid Field Office Pakistan and Cordaid s Partners, CRS and ODP&TWO. The programme had a duration of 16 months, starting in August 2010 while it was closed at the end of November 2011. SHO funding had to be spent within 12 month, i.e. before mid-august 2011. In the 16 months period all activities and output targets as defined in the different project proposals have been achieved. 5150 kits of non-food items (kitchen utensils, bedding, plastic sheets etc.) and 2900 food packages have been distributed 783 new shelters have been constructed, 125 houses were repaired, 300 tents were distributed and 2500 families received plastic sheets for temporary shelter 2301 latrines were constructed (adjacent to new transitional shelters) 107 water systems were rehabilitated 3000 families received aqua tabs to disinfect contaminated water 7500 hygiene kits were distributed and 591 hygiene promotion sessions were conducted 3751 families benefited from a cash and vouchers scheme providing them agricultural inputs (seeds, fertilizer) and cash to pay for ploughing of their land and water for irrigation. 46 Cash for Work schemes were implemented, mostly rehabilitation of irrigation systems. The health programme in Shangla assured medical care in 4 Union Councils, through deployment of medical staff, mobile health units (MHU s) and provision of medicines during the project period. Repairs were done on 3 Basic Health Units (BHU s) and the district hospital and the BHU s received medical equipment and furniture. Trainings were given to medical staff to strengthen their capacity. However implementation of the programme has not been without problems, especially the shelter components of the programme executed by Cordaid itself in Shangla and Kohat districts. There have been major delays in the start-up of the shelter projects and later on during its implementation.
A major cause for the delay were problems with the recruitment of international staff, especially in the start-up phase. Except for the early emergency response of the health team in early August 2010, which was already present in the region and could respond rapidly, Cordaid didn t have the capacity to respond timely. Also, weaknesses in the procurement and problems with suppliers caused delays throughout the implementation of the programme. It was also found that the needs assessments for the shelter projects showed major deficiencies resulting in an overestimating of the needs. There were major doubts about the relevance for an emergency response in the last phases of the shelter project in Shangla, when the real needy beneficiaries were already served, and of the repairs of the houses in Kohat. The needs assessments generally lacked a systematic approach to define a proper intervention strategy, such as a partner strategy or an emergency response and exit strategy for its health programme. Also no proper systems were in place, until late in the programme, for a remote control approach as required for the high security risk area of Kohat district. CRS (Catholic Relief Service) has been performing well in both programmes, in Sindh and in the North-Western districts, that were co-funded by Cordaid. CRS is already active in Pakistan for more than 50 years and has experience with emergency response programmes in Pakistan since the big earth quake of 2005. It has a well-established office in Islamabad and could rely on experienced local staff and international staff and the support of its regional office. The interventions were well structured, from the needs assessments to the actual implementation, and lessons learnt from earlier projects were integrated in the new projects (example: the cash and voucher scheme). It was found that all targets have been achieved and in time. CRS has developed an effective partner strategy. It implemented all the projects in cooperation with local partners. As these partners mostly lack experience in emergency response programmes, especially on a large scale as required after the floods of 2010, it developed a system wherein CRS provides close supervision; the approach can be defined as an on the job training. Starting with close supervision, gradually more responsibility was assigned to the partners. Also the two local partners of Mensen met een missie have performed well. Their major advantage was good knowledge of the communities where they implemented the projects, mainly distribution of NFI s, hygiene kits, food packages and tents. The beneficiaries praised especially the transparency of the registration and distribution process and the orderly way in which it was organised. Approval of the project proposal by Cordaid has taken a long time; therefore the implementation of the project was much later (Nov. Dec. 2010) as originally planned. At that time the local NGO s had already lost one of their main comparative advantages, namely to be able to respond rapidly when the international organisations have not yet arrived. In Nov. Dec. there was a higher risk for duplication with the assistance arriving from other agencies. The recommendations which are formulated target especially Cordaid HQ s, addressing weaknesses in the programme performance of Cordaid as an implementing agency. We recommend that Cordaid: should consider how to improve its capacity to recruit qualified staff in a timely manner. should review its needs assessments procedures and tools for emergency response programmes. Joint assessments with other INGO s should also be considered. should consider if it has developed adequate guidelines for the implementation of programmes in high security risks areas. We recommend further that Cordaid should review its policy for partnership with local NGOs in order to improve its contribution at capacity building of local NGO s (and DRR), and pay special attention in future emergency response programmes to the needs of vulnerable groups and seek ways to assist them to assure equity (instead of equality). ii
Table of Contents Executive Summary...i Table of Contents...ii 1 Introduction...1 1.1 General background...1 1.2 Methodology...2 1.3 Limitations of the study...3 2 Programme description...6 2.1 Cordaid s programme in Shangla...6 2.1.1 Early response...6 2.1.2 Health Programme...6 2.1.3 WASH Programme...7 2.1.4 Shelter programme...8 2.2 Cordaid s shelter programme in Kohat...8 2.3 CRS Sind Programme...9 2.4 CRS Latrines project in Shangla, Kohistan, Swat districts...10 2.5 ODP & TWO Programme...10 2.6 Total funding and programme outputs...10 3 Assessment of the individual programmes...14 3.1 Cordaid s programme in Shangla...14 3.1.1 Early response...14 3.1.2 Health Programme...14 3.1.3 WASH programme...18 3.1.4 Shelter programme...19 3.2 Cordaid s shelter programme in Kohat...23 3.3 CRS Programme Sindh...24 3.4 CRS Latrines project in Shangla, Kohistan, Swat districts...27 3.5 ODP & TWO Programme...27 4 Overall Assessment of the Programme...30 4.1 Cordaid s performance...30 4.1.1 As Implementing Agency...30 4.1.2 As Funding Agency...34 4.2 CRS Performance...34 4.3 Performance of ODP and TWO...35 4.4 Cross cutting issues...36 4.4.1 Respect of Sphere guidelines and Code of Conduct...36 4.4.2 Cost effectiveness...36 4.4.3 Gender and vulnerability issues...37 5 Recommendations...38 ANNEXES...40 Annex 1. Terms of Reference...41 Annex 2. List of persons interviewed and sites visited...45
1 Introduction 1.1 General background Pakistan s 2010 floods are considered amongst one of the major disasters of the 21 st century due to the disaster s widespread geographical scale and distribution, the unprecedented caseload of affected population and its economic impact. According to the Pakistan s National Disaster Management Authority (NDMA), the 2010 floods constitute the country s largest disaster as some 20 million persons, approximately 10% of the country s population, was affected, despite the scale of the disaster, casualties remained relatively low at approx. 2000. The 2010 Pakistan floods began in late July, and following heavy monsoon rains that lasted for more than eight weeks, they evolved from normal flash floods into a massive disaster affecting large parts of the country. The floodwater waves washed down from north to south and at one point the Indus River submerged a fifth of the country s land mass. Initially, the provinces of Balochistan and Khyber Pakhtunkhwa (KPK) were flooded. In mid-august, as flood waters flowed south Punjab and Sindh provinces experienced resultant widespread flooding. The floods directly and/or indirectly affected 78 of Pakistan s 121 districts, devastating and submerging entire villages, roads, bridges, water supply and sanitation infrastructure, agricultural lands, livestock as well as washing away houses and health and education facilities. 22 July: Heavy monsoon rains fell in Khyber Pakhtunkhwa and Balochistan displacing thousands and killing hundreds of people. 29 July: Flash floods and landslides force massive evacuations and displacement of people as floodwaters flow from north to south and rivers converge with the Indus. 6 August: The floods enter Sindh breaching banks on the Indus and flooding the western areas of the province. Mid-August: The monsoon rains and floods had impacted an estimated 160,000 square kilometres of land, affecting over 18 million people across the country. 25 August: More than 800,000 people are cut off the floods. 26 September 2010: Flooding in southern Sindh where the embankments of Lake Manchar breached caused an estimated 1.5 million people to be displaced in a matter of days. The impact of the flood was very diverse in each province due to the changing nature of the disaster, the different levels of preparedness (in terms of capacity, resources and systems in place), and the access to individual and common resources. Kyber Pakhtunkhwa (KPK) was only affected by flash floods while other provinces where exposed to both flash and riverine floods. Sindh was the worst affected province, as the Indus River did not find an outlet due to the flat topography of this area. While waters receded within days in Balochistan and KPK, it took several weeks in Punjab and months in some areas of Sindh. Where water receded rapidly most of the displaced population was
able to return during the months of August and September. In October most of the affected population in these areas had returned. In Sindh some 7.3 million people were affected by the floods, In Punjab approx. 6 million, and in KPK some 3.8 million persons. On the 12 th of August 2010, the Aid Agencies in the Netherlands started a joint fund raising campaign for an emergency response to the Floods in Pakistan. Total donations amounted to 27.5 million, of which Cordaid received approx. 5 million. Cordaid was active in Pakistan from 2003. From 2005, following the earthquake, it had been involved in earthquake relief work and in the IDP crises in KPK. From November 2007 till early 2009, Cordaid continued a third phase of earthquake relief work that focused on housing and education. In 2009, in Shangla district (KPK) a health programme for IDP s started aiming to strengthen the access capacity of health structures in the district. Cordaid was implementing also an education programme in Shangla as well as starting up a WASH-Health intervention in Kohat district, also in KPK. Shangla district was severely affected by the heavy monsoon rains at the end of July, resulting in flash floods, landslides and houses and other infrastructure damaged by heavy rains. The health team of Cordaid and its local partner Cavish responded immediately, providing medical assistance and assuring medicines supplies in the worst affected areas. The team conducted a first rapid need assessment in early August identifying the fields in which emergency response was needed, i.e. shelter, NFI s, WASH and health. On the basis of this rapid assessment it was decided by Cordaid to scale up its programme in Shangla, focusing on shelter, WASH and health. Later on it was decided to start-up a shelter rehabilitation programme in Kohat. In Shangla and Kohat districts Cordaid implemented the programme itself (total budget: approx. 3,25 million). CRS received additional funding for its shelter programme in Shangla, Kohistan and Swat districts for the construction of latrines, to complement the budget of other donors which didn t provide for funding of this component. (budget: 458.655). Cordaid co-funded the CRS Emergency Response programme in Sindh (budget: 1.592.894). In Punjab, two local partner organisations of Mensen met een Missie (CMC), one of the constitutional member organisations of Cordaid, received funding for an early emergency response (total budget: 173.707). 1.2 Methodology The main purpose of the evaluation study was defined in the ToR as to measure the performance of Cordaid in the 2010 Flood Response Programme, looking at the overall performance of Cordaid HQ, Cordaid Field Office Pakistan and Cordaid Partners (CRS and ODP TWO). It was further elaborated as to assess: The suitability (appropriateness) of the operation and the level it has been carried out. The degree to which the objectives pursued have been achieved (effectiveness) and whether the means employed have been effective. To quantify the impact of the operation in terms of outputs. To analyse: Cordaid s role as coordinator and donor as well as an implementing agency. Cordaid s partners performance as implementing agencies. The link between relief, rehabilitation and development in the flood response. To check: - if the principles contained in the Code of Conduct and Sphere guidelines have been respected. To formulate: - precise and concrete recommendations to improve future operations in Pakistan and Cordaid globally. 2
The ToR further identified a list of issues to be covered in the study, including analysis of the relevance, effectiveness, cost effectiveness, efficiency and impact of the programme, and gender issues as a cross cutting theme. The ToR is attached in Annex 1. The evaluation study was carried out in the period of 14 November 3 December 2010. The evaluation team consisted of Mr Ton de Klerk (team leader), Dutch nationality and expert in evaluation studies of humanitarian assistance programmes, and Mrs Shahida Sultan, Pakistan nationality and expert in M&E and educational programmes. The team leader had a briefing on November 14 th at Cordaid s HQ s in The Hague. On the 17 th, he had a telephone interview with the ad-interim Head of Mission (Dec. 2010 Jan. 2011; June July 2011). The team received all required programme documents from HQ s, Field Office in Islamabad and in the field. Field visits were carried out from November 20 th to December 2 nd, followed by a debriefing at the Field office of Cordaid in Islamabad on December 3 rd. A debriefing was held at Cordaid HQ s at the 15 th of December. Feedback received during the debriefings is incorporated in the report. The field visits started with a briefing and interviews of senior programme staff of Cordaid in the Islamabad office (Nov. 20 th - 21 st ). Next the team visited Southern Punjab (Multan) where assistance had been provided to flood affected villages by two local NGO s, ODP and TWO (Nov. 22 nd - 23 rd ). From Multan the team travelled to Northern Sind (Sukkur) to visit the project locations of the CRS programme (Nov. 25 th - 26 th ). Returning to Islamabad on Nov. 26 th we had additional interviews with Cordaid programme staff and the shelter team of Kohat on Nov. 27 th. The second week we visited Shangla region, where the team spent two days with Cordaid staff and visited villages benefiting of assistance by the Cordaid programme (Nov. 29 th and 30 th ) and one day with CRS (Dec. 1 st ). On Dec. 3 rd we had a meeting with the Country Director and the Coordinator Partnerships of CRS. During the field visits the emphasis was on discussions with programme staff and group meetings with beneficiaries. The evaluation team, composed of a male and a female evaluator, could have separate meetings with male and female beneficiaries. Some government representatives (DCO s of Jabobabad Sindh and Shangla districts, senior engineer of TMA Shangla) and medical staff of the public health services could also be met. In addition, we had meetings with staff of local partners of CRS and of Cavish, a local partner of Cordaid. We conducted semi-open interviews with programme staff, government representatives and local partners as well as in the group meetings with the beneficiaries, following a list of key issues to be discussed which were identified by the evaluation team before each interview. The interviews with the beneficiaries served the purpose of assessing in particular beneficiaries satisfaction with the assistance provided, the timeliness of the interventions, beneficiaries involvement in the programme, checking if proper beneficiaries selection procedures were observed etc. The number of interviews which were conducted was small, but the programme reports were generally of good quality; through the interviews we could check the accuracy of the reports. 1.3 Limitations of the study A major limitation for the study has been the short time available for the field visits. Only one and half day was available to assess the CRS Sind programme, an integrated programme with NFI s, Shelter, WASH and livelihood sector activities and covering some 30 villages. Only two days were available to assess Cordaid s programme in Shangla with activities in the NFI, Shelter, Health and WASH sectors; the shelter programme alone covered 66 villages 1. We could visit only a small sample of villages and, apart from programme staff, conduct interviews with a small number of other 1 The programme of TWO in Punjab and the Cordaid programme in Kohat could not be visited due to time constraints 3
stakeholders. Therefore some findings of the evaluation, especially regarding the effectiveness (qualitative) and the impact of the programme, should be considered with caution, especially where we indicate that the findings are based on just a few observations. Planning our field visits we tried to arrange for random sampling of the villages to be visited. But we succeeded only partially, due to the far distances of many villages, especially in the mountainous region of Shangla with many of the villages on a hiking distance of 20 40 minutes from the main road, and the fact that we wanted to visit villages where several sector interventions were carried out simultaneously. In the end we had to choose for villages near to the road and where multiple interventions could be assessed. The programme of Cordaid had closed down just before our evaluation study 2. The local field staff had already left and thus couldn t be met. During our visit we were accompanied by the project coordinator of the shelter project and the M&E officer of the shelter /WASH project, whose contracts had been prolonged for our visit. In the field we also met some, locally recruited, social mobilizers of the shelter programme. Besides we had a short meeting with the former project coordinator of the health programme. Because we got better informed about the shelter project, the assessment of Cordaid s programme in Shangla will consequently be more focused on this component. Due to a high turnover of expatriate staff it was difficult to get information especially on the start-up phase of the programme. But we hope that these gaps have been filled by meeting (accidently) the acting head of mission in the period Oct. Dec. 2010, the above mentioned telephone interview with the ad-interim head of mission and the feedback we received on our questions from the senior programme officer for the Pakistan programme at Cordaid HQ s. Because of the limitations, especially the time constraint, we have focused more on a few issues which we considered of main importance, after studying the programme documents, to assess Cordaid s performance, such as programme management and partnership relations. The evaluation team didn t have in-depth knowledge of all sectors covered by the programme. Due to this, in combination with the time constraint, not all questions defined in the ToR could be dealt with adequately, for example those related to logistics, warehouse management and appliance of Sphere standards in all different sectors (Health, WASH). Besides the programme reports, we relied heavily on the information gathered through the interviews with programme staff. This information was triangulated with feedback we got from beneficiaries and other stakeholders, and through direct observations (shelters, utilisation of equipment distributed etc.). We believe that, nonetheless all these limitations we succeeded in making a reliable assessment of the programme. 2 It was planned to carry out the evaluation while the field staff would still be available but due to delays in the visa application process of the team leader and problems with obtaining a NOC (Non Objection Certificate) to visit the Shangla district, the programme had to be re-arranged. 4
Table 1. Overview of meetings and field visits. Nov. 20 th Nov. 21 st Nov. 22 nd Nov. 23 rd Nov. 24 th Nov. 25 th Nov. 26 th Nov. 27 th Nov. 28 th Nov. 29 th Nov. 30 th Dec. 1 st Dec. 2 nd Dec. 3 rd Briefing session with the Head of Mission, Head of Programme and Administrative Manager of Cordaid Pakistan and interview with the Logistics Manager. Interviews with the Programme Managers Health, and WASH-Shelter, the former Acting Head of Mission (Oct.- Dec. 2010), and a representative of Cavish. Afternoon: travel to Multan (Southern Punjab) Briefing session in the office of ODP, followed by a visit to two villages where group meetings were held with beneficiaries, and a visit to the offices of a local partner (NGO) of ODP involved in the implementation of the programme. Meeting with staff of TWO were met in the office of ODP, followed by a meeting with beneficiaries (and ODP s implementing partner) of a third village. Travel over land to Northern Sind (Sukkur). After arrival interview with the Head of Office and the M&E Officer of CRS Sindh. Three villages were visited in Jacobabad district, accompanied by the Programme Officers Livelihood, Shelters and WASH of CRS. In two villages we had separate group meetings with men and women; in the third village we visited some beneficiaries of the shelter programme. In the evening we had a meeting with the Programme Managers and the District Coordination Officer of Jacobabad district. Meeting with the programme staff of the shelter programme of the local NGO Implementing partner for CRS. In the afternoon: travel back to Islamabad. Interview with the Administrative Manager of Cordaid Pakistan, and meetings with the Programme Manager and the local staff of the shelter programme in Kohat Travel to Shangla district (Besham), where we met with the project coordinator of Cordaid s shelter programme and the M&E officer for Shelter/WASH. Meetings in Alpuri with the former project coordinator of the Health programme, the Senior Medical Officer and a female Gynaecologist of the District Hospital (DHQ), the District Coordination Officer of Shangla, and the senior engineer of the Tehsil Municipal administration (TMA), in charge of water systems. It was followed by a visit to one village, where we had separate group meetings with men and women and visit to some beneficiaries in their new shelters. Second day of field visits with Cordaid. Separate group meetings with men and women in two villages. Visit to a BHU (Basic health Unit) and interview with the medical doctor. On our return in Besham, meeting with Head of Office of CRS programme in Shangla / Kohistan / Swat. Field visit with CRS, accompanied by the Project Manager Shelter. Visit to one village, where separate meetings were held with men and women. Meetings with two local NGO s, implementing partners for CRS shelter programme. Travel back to Islamabad. Interview with former field officer of Cordaid, involved in the Shangla Programme from August 2010. Meeting with Manager Human Resources of Cordaid. Meeting with country director and coordinator partnership relations of CRS. Debriefing for CRS senior staff. 5
2 Programme description 2.1 Cordaid s programme in Shangla. 2.1.1 Early response Due to the presence of its health programme in Shangla Cordaid could and did respond rapidly after the devastating heavy rains causing floods and landslides in the district. Shangla was one of the most affected districts in KPK province. Four Mobile Medical Units (MMU s) moved immediately into the most affected areas providing medical assistance, i.e. curative care and provision of medicines. The teams stayed overnight at the BHU s (Basic Health Units) or dispensaries. Medicines were forwarded by means of mule carriage using the mountain roads, since the main roads were heavily damaged and bridges were washed away. Within the first month after the floods Cordaid also distributed 900 NFI kits containing kitchen items, bedding and plastic sheets. Early August a first rapid assessment was done by the Cordaid team, assisted by its local partner Cavish, to assess the damage and identify the priority needs for emergency assistance and early recovery. Health, WASH, Shelter and distribution of NFI s were identified as the priority intervention areas. While in this early phase an emergency response was anticipated (emergency shelter, provision of WASH services to temporary settlement areas, i.e. camps, provide affected households with water purification tablets, jerry cans etc.), later on the programme strategy shifted towards early recovery interventions. Few people lived in temporary shelter such as camps or public building; most affected families found refuge with host families or could rent temporary housing. WASH interventions shifted to rehabilitation of water systems. Many water systems had been damaged creating health risks since people had to take recourse to unsafe water sources. 2.1.2 Health Programme Expenditures: 512. 104 The overall objective of the Cordaid Health program was to reduce mortality and morbidity and to improve the health status of the population in Shangla District by strengthening the existing Health System. Health care activities were conducted in collaboration with local partners, the Ministry of Health (MoH), and WHO. Cordaid provided health care services to the population of Shangla District through the seconded MoH staff as well as Cordaid contracted staff members. Services were delivered in static and mobile sites where medical teams consisting of one doctor and one dispenser were used per each supported facility. Cordaid did minor repairs to rehabilitate the government health facilities in the area, by installation of electricity and repair of faulty doors and windows. In total 3 BHU s (Basic Health Units) were rehabilitated. A hydropower station was installed at the DHQ s in Alpuri Access to basic health care services was improved by running Mobile Medical Units (MMU) in remote areas. Increased awareness on the prevention of diseases is part of the strategy as well as efforts to improve the behaviour of the local population towards health & hygiene. Cordaid provided basic health services by providing free health consultations and free medications to the affected population, promote good health practices through health and hygiene education sessions, while supporting the local health authorities by capacity building of personnel of the Ministry of Health. Cordaid s strategy in the early stage was focused on provision of emergency health services, through static and Mobile clinics. A second stage saw a shift to early recovery which included activities related 6
to repair and rehabilitation of the health facilities and provision of support to the MoH through medicines supply, staffing, provision of medical equipment and furniture, incentives for staff and capacity building through trainings. Prior to the floods there were acute shortages of health professionals in the District. All BHU s were under staffed, often with no medical doctor. Due to the presence of the Taliban there were very few female health workers. There was only one female medical doctor/gynaecologist based at the DHQ in Shangla District, seriously affecting most women s opportunity for access to maternity healthcare. LHV s (Lady Health Visitors) assigned at the BHU s received incentives from Cordaid during the project period and received training on MNCH (Maternal, New born and Child Health Care). A provincial DHIS (District Health Information System) cell has been established by the KPK Government, which has conducted introductory trainings on DHIS system in 13 districts of KPK for implementation of DHI. Shangla District was not included in the role out of the Government programme. Cordaid took the initiative in this regard and was able to recruit a DHIS coordinator who worked to build the capacity of the MoH staff in health information system management and trained facility based staff in accurate data entry in the required reporting formats. In all four BHU s included in the programme community health committees (CHC s) were established and trained. This was to ensure that local people had a voice and a part in the decision making. A Leishmaniasis outbreak occurring in May 2011 required Cordaid health team to provide curative and preventive intervention in the Jatkool area of Shangla. This Leishmaniasis project was initially not included in the programme. In collaboration with WHO and the district MoH, Cordaid sent out a team of a medical doctor and dispenser to the area. Medicines were provided by WHO. Cordaid distributed mosquito nets and hygiene kits and shared health education on disease prevention. 2.1.3 WASH Programme Expenditures: 289.019 In total 80 community water schemes (gravity) have been rehabilitated. Funding for the first 50 schemes was provided by UNICEF. Cordaid had planned to fund an additional 20 schemes but as a result of savings 10 extra schemes could be rehabilitated. The work consisted of rehabilitation of the water sources, installing main pipe lines connecting the sources with the distribution tanks, construction or rehabilitation of distribution tanks and laying of tertiary distribution lines connecting to the houses. The project was implemented in 4 UC s (Union Councils). Project Facilitation Committees (PFC s) were formed in each location. These committees were responsible to solve issues regarding the path of the main lines, ownership of the source and other related issues. They also organised the work on the rehabilitation of the water source and laying of the main pipelines, under supervision of the Cordaid engineer. Each committee signed an agreement to complete the work themselves receiving payment on completion of the work. Cordaid did not pay for work in the final stage, the community were required to dig and lay the tertiary pipelines which connected each home to the water supply. Before the rehabilitation of the water systems, aqua tabs water purification tablets were distributed to disinfect the water collected from unsafe sources. Hygiene kits and jerry cans were distributed. Hygiene awareness sessions were held, sensitizing on appropriate essential health and the means to adopt good hygiene practice, also for students in various schools. By late February 2011 it became clear that there would be an under spending of the UNICEF funds and therefore Cordaid developed five additional activities to promote hygiene. The activities included a cricket match displaying hygiene messages, training of WASH committees, celebration of World Water Day, celebration of Sanitation days and TOT sessions for hygiene promotion. 7
2.1.4 Shelter programme Expenditures: 1.361.163 A total of 723 semi-permanent shelters have been constructed in 5 UC s (66 villages), that were most affected by the floods, landslides and heavy rains of July - August 2010. The shelter packages contained a latrine which was built adjacent but separated from the house. Initially the target had been set at 750 houses to be constructed in 4 UC s. However, after phases 1-3 it was clear that there would not be enough beneficiaries in these four UC s following the initial selection criteria. Two changes were therefore proposed and approved by Cordaid: A fifth UC (Damouri, still in Shangla district) to be included in the area of operation, enabling to find more eligible beneficiaries for shelters; A number of classrooms of flood affected government schools and BHUs to be included, allowing more shelters within our area of operation. Henceforth, 23 classrooms have been constructed on school premises in flood-affected villages and 4 rooms for different functions (waiting room, delivery room, OPD treatment room) have been constructed on BHU premises in flood-affected villages. Cordaid formed Project Facilitation Committees (PFCs) in each of the 66 villages. The role of the PFC s was: - to prepare an initial list of households eligible to receive shelters; - assist Cordaid s shelter staff in the re-assessment process of this initial list; - facilitate establishment of agreements between landowners and households who needed temporary sites; - confer with eligible households to identify suitable sites for construction; - arrange voluntary community labour to perform site preparation on behalf of households without an able-bodied member; - assist in arranging delivery of materials kits to household construction sites; - verify completion of construction completion jointly with Cordaid; - and provide trouble-shooting and problem-solving as necessary. The construction materials were transported by Cordaid to a nearby distribution point at the main road where they were collected by the beneficiaries. Most of the houses were constructed by carpenters. Skilled people were identified from the beneficiaries communities who received a special training. Carpenters were awarded to build shelters as much as they had capacity. The trained carpenters hired more unskilled persons from the communities. Overall 40 carpenter teams (160 persons) were supported for capacity building and income generation through the programme. Similarly 80 vulnerable beneficiaries were also identified and trained for masonry works. A complete masonry toolkit including a practical handbook was awarded to each trainee to support them for a good start of skilled jobs. 2.2 Cordaid s shelter programme in Kohat Expenditures: 193.023 A rapid needs assessment done by Cordaid in August 2010 identified 283 flood affected HHs within the local population in 3 selected Union Councils of Kohat district. The assessment revealed 70 HHs with completely damaged houses and 213 HHs with partially damaged houses. Data collected in August 2010 were found to be unsatisfactory to plan effective response thus a new physical assessment was carried out in January 2011 to examine gravity of damage on each affected building. As the re-assessment showed that the project budget would not be completely utilized in the three initially selected UC s, it was decided after consultations in the Shelter Cluster and with the PDMA (Provincial Disaster Management Authority) to include two more UC s in the project. Following the needs assessment it was decided to construct 60 new shelters and to repair 110 houses with major damage and 15 houses with minor damage in the 5 UC s. The design of the new 8
houses differed from the semi-permanent shelters in Shangla district. Cordaid in agreement with the community designed a one room shelter constructed out of brick and rein-forced cement concrete. The work approach is the same as in the shelter programme in Shangla, with village shelter committees assigned the same role as in Shangla, except identification of beneficiaries which was already done, and the training of masons and carpenters to execute the construction and repairs. 2.3 CRS Sind Programme Expenditures: 1.592.777 CRS was awarded a grant from Cordaid to provide NFIs (emergency shelter and hygiene kits), WASH support, and agricultural inputs for cropping seasons through a combination of commodity vouchers and cash grants. The beneficiary households for the three project components overlapped to the greatest extent possible, while ensuring that they met the targeting criteria for each intervention. The project goal was that flood-affected families rebuild their livelihoods and their communities. There were four objectives: - targeted families have access to NFI s to meet their immediate hygiene and shelter needs; - flood-affected households have access to sufficient clean water to meet their essential household needs; - flood-affected farming households have resumed farming; - and floodaffected households live in locally-appropriate shelters that provide the basis for disaster recovery. For NFIs, CRS used a blanket coverage approach in the villages in the targeted UCs; all had sustained great damage from the floods. Beneficiary selection for the NFI/hygiene kits followed the criteria established for the shelter program total destruction or severe damage to the home. Prior to distributions in a village, CRS mobilized communities to form village committees. Active community members signed up to participate in these and were approved by their peers. The VC s created by the NFI/Shelter program team were later used in the WASH, livelihoods and shelter programs. Aassessments conducted immediately after the flood showed hand pumps had been left partially or fully damaged after the flood. Poor hygiene practices, such as open defecation in fields, further contaminated water sources. These results led CRS to focus on providing clean water to communities and teaching them proper maintenance of the water system and better hygiene practices. With Cordaid funding, CRS reached 27 villages in two UC s in District Jacobabad with water supply scheme interventions. Also hygiene promotion sessions were conducted separately for men and women. CRS began implementation of its livelihoods recovery project in Sindh in September 2010 after conducting a rapid needs assessment. Funding from Cordaid covered beneficiary need for agriculture assistance in the two seasons immediately after the flood: Rabi (winter) season or Kharif (spring) season. Wheat is the primary crop for Rabi season and rice is the primary crop for Kharif season. For the Rabi season, beneficiaries received three separate vouchers to be redeemed for wheat seed, fertilizer and vegetable seed. Voucher packages were designed to generously cover one-acre for wheat cultivation and the total value of the package was 176 USD. Complementing the voucher package was a cash grant of 50 USD which was calculated based on the cultivation costs of tractor rental. The cash grants were checks to a reputed bank in the area. Similar to Rabi season, commodity vouchers and cash grants were distributed for Kharif season, but the amount of money for the cash grant was increased to 95 USD in anticipation for beneficiaries needing fuel for pumping water from the tube wells as the primary crop for Kharif season is rice. In addition to this activity, a cash-for-work program was started to repair the productive infrastructure of communities. Schemes took an average of between 5-8 days to complete. Through Cordaid, CRS rehabilitated 45 irrigation channels and 1 link road. Through the shelter project 10,000 plastic sheets were provided, which made possible the construction of 2,500 transitional shelters. Initially it was planned that Cordaid would also fund 9
(budget: 500.000) construction of 1050 transitional shelters, but because CRS feared procurement problems and it would not be able to finish the project in time (SHO deadline) this component was cancelled. However, CRS constructed transitional shelters with funding from other donors. As a result Cordaid returned 500,000 Euro to the SHO fund to be redistributed among SHO partners CRS worked through three local partners GSF (Goth Singhar Foundation), RDF (Research Development Foundation) and YAP (Youth Action Pakistan) to implement the project in Sindh. 2.4 CRS Latrines project in Shangla, Kohistan, Swat districts. Expenditures: 458.655 CRS received funding for its shelter programme in Shangla, Kohistan and Swat districts for the construction of latrines, to complement the budget of other donors. The latrines were constructed adjacent to the shelters. Latrine and bathing space materials were provided to 2301 HH s. In order to build the transitional shelters and latrines and bathing spaces, CRS used a Cash for Work approach in order to support local skilled resources, build the capacity of unskilled workers, facilitate community ownership in the project and inject cash into flood-affected communities. The same workers who constructed the transitional shelters also constructed the latrines and bathing spaces. CRS worked with local partners ISWDO (Indus Social Welfare Organization) based in Kohistan, ROAD (Rural Organization for Awareness and Development) based in Shangla, and LASOONA based in Swat. 2.5 ODP & TWO Programme Expenditures: 173.703 In November December 2010, ODP distributed two monthly rations of food items to 700 families in 6 villages (from 7 UC s) in Southern Punjab. Tents were distributed to 300 families in the same villages and one additional village. TWO distributed a one month ration of food items, a set of kitchen utensils and a hygiene kit in 12 UC s to 1500 HH s. In addition 4 medical camps were organised in 4 different UC s in December and January. 2.6 Total funding and programme outputs Expenditures: 4.658.954 Figures regarding total funding and outputs of the programme are presented in Table 2 4 10
Table 2 Total Programme Funding Total expenditures from 01 August 2010 and 31 October 2011 SHO People in Need CAFOD CERF Caritas Germany Caritas Tjechie Unicef Cordaid adoptions TOTAL Cordaid, Shangla 1.671.912 153.923 170.000 37.511 91.366 8.278 31.722 76.084 2.240.796 NFI's 27.355 42.154 69.509 Health 230.084 74.509 170.000 37.511 512.104 Shelter 1.181.518 79.414 66.301 33.930 1.361.163 Wash 223.955 25.064 8.278 31.722 289.019 Cordaid, Kohat Shelter 73.622 91.379 28.022 193.023 CRS, Shangla, Kohistan, Swat Latrines 387.516 71.139 458.655 CRS, Sindh 1.576.847 15.930 1.592.777 NFI 97.062 97.062 Shelter 174.368 174.368 Wash 108.003 108.003 Cash & Vouchers 881.934 881.934 Program Support 1 331.527 331.527 ODP, Punjab TWO, Punjab 124.878 48.825 173.703 TOTAL 3.834.775 245.302 170.000 37.511 119.388 8.278 31.722 211.978 4.658.954 Table 3. Expenditures per Sector Total expenditures from 01 August 2010 and 31 October 2011 NFI's 376.694 90.979 467.673 Health 239.084 74.509 170.000 37.511 521.104 Shelter + Latrines 1.859.112 170.792 94.324 105.069 2.229.297 WASH 397.829 25.064 8.278 31.722 462.893 Cash & Vouchers 962.056 15.930 977.986 TOTAL 3.834.775 245.301 170.000 37.511 119.388 8.278 31.722 211.978 4.658.953 1. Programme support costs of local partners 11
Cordaid, Shangla Table 4. Overview of Programme Outputs NFI's Food Shelter WASH Livelihood Health 3 1000 kits Shelter + latrines Cordaid, Kohat 60 new shelters + 125 repaired CRS, KPK 2301 CRS, Sindh ODP, Punjab TWO, Punjab 2650 kits 1500 kits TOTAL 5150 NFI kits 1400 1 packages 1500 packages 2900 Food packages Latrines Water systems Aqua tabs & storage items 723 2 723 80 benef. 3000 HH's Plastic sheets for 2500 HH's 300 tents 783 new shelters. 125 houses repaired. 300 tents. 2500HH s got plastic sheets 2301 Latrines Hygiene kits Hygiene promotion sessions 6000 175 in villages + 34 in schools Agriculture: Cash& voucher 27 382 3751 commodity vouchers + cash grants 107 Water systems 3000 HH's Received aqua tabs Cash for Work 46 schemes Consultations 93.566 1500 2430 7500 Hygiene kits 591 Hygiene Promotion sessions 1. 700 beneficiaries received two monthly packages 2. 23 additional classrooms + 4 additional rooms at BHU's were built out of remaining budget 3751 HH's Received Cash & Vouchers 46 Cash for Work Schemes 95.996 medical consultations Medicine supply. Cordaid Shangla Standard list of essential medicines provided by WHO were supplied to the clinics and DHQ Shangla supported in the program Training medical staff Cordaid Shangla 8 trainings were conducted. Total # of participants: 109 8 trainings conducted: 109 participants 3. The health programme consisted of a wide range of other activities. For a complete overview, see par. 2.1.2 and 3.1.2 12
Photo 1: CRS shelter constructed in Shangla district. Entrance in the middle; kitchen on the left and latrine on the right. Photo 2: Cordaid shelter constructed in Shangla district. 13
3 Assessment of the individual programmes. 3.1 Cordaid s programme in Shangla. 3.1.1 Early response The early response by the health team immediately after the floods was highly appreciated by the beneficiaries, other stakeholders (DCO, medical staff of MoH) and the local staff of Cordaid. The medical teams were among the first ones to visit the devastated areas and could provide timely much required medical support. People had suffered a lot as the roads were destroyed and there was no access to other health facilities. They set up Diarrhoea Treatment Centre (DTC) and saved thousands of people including children which was possible due to the timely response. (Senior Medical Officer, DHQ Alpuri ) The distribution of the NFI s was a blanket distribution. In two of the three villages we visited in Shangla it was found that not everybody had benefited. Families living along the main road had received the NFI s, but those living in the mountains had not. Especially among the women there were complaints that they had not received any NFI s. A Cordaid staff member, who was field officer at the time of the distributions, explained it by the chaotic situation at that time. There was insufficient time to inform all beneficiaries. Those who had received NFI s were highly satisfied with the assistance. The women who had not benefited were disappointed. All my belongings were washed away in flood. Cordaid has given me 2 blankets, 1 carpet, 2 cooking pots, 1 cooking pan, 4 plates, 1 hygiene kit, 1 big box, and 1 lantern. I am happy as I needed them. (female beneficiary, Derai) 3.1.2 Health Programme Due to its presence at the moment of the floods the health team could respond quickly and adequately in the emergency and in the early recovery phase. Its interventions during this period have been highly relevant. Also the repairs of the BHU s, of damages caused by the floods and heavy rains, can be qualified as an appropriate emergency (recovery) response. In particular the rental and equipment of an alternative building in Shahpur which was set-up as a temporary clinic, since the existing structure of the BHU was beyond use after the floods, can be mentioned. But the objectives of the programme, except for the assistance to be provided in the early recovery phase, were basically development oriented. Prior to the floods there were acute shortages of health professionals in the District. All clinics were under staffed, often with no doctor. The BHU s were poorly equipped. Many of the medical staff were poorly motivated. Political instability and fear combined with long term mismanagement on behalf of state and non-state actors as well as inherited financial constraints further enhanced by lack of transparency and accountability lead to poor infrastructure and practically non-existing social welfare services (source: Project proposal for health programme). With the short duration of the programme - initially 6 months, later extended to 15 months it was unrealistic to expect sustainable results. The exit strategy as defined in the project proposal was to hand over to local authorities, expecting that training of medical staff and better equipment of the clinics would have a lasting effect on their 14
performance and the quality of the health services provided to their constituencies in the long run. After withdrawal of Cordaid s medical teams staff shortages would however still remain while the withdrawal of the incentives of which medical staff benefited during the project period might also impact their motivation. Later on, from August 2011, an exit strategy by handing over to another INGO has been pursued. Maltheser International which specializes in Healthcare Programmes and has been operational in Pakistan for the last 6 years showed interest. Discussions were successfully concluded and resulted in a MOU for the handing over of the programme on October 31 st. Maltheser has developed a proposal that builds on the work carried out by Cordaid. The proposal reduces the financial support to the Health Authorities but continues the support in primary healthcare. Maltheser proposes to focus on underdeveloped components of the health system, such as obstetrics, the training of traditional birthing attendants and support for the midwifery training centre as an example. Currently Maltheser has secured 8 months funding from Caritas Germany, but it expects to be able to obtain longer term funding (2 3 years). Programme effectiveness 3 All objectives, in terms of outputs (and activities), as defined in the project proposal have been achieved. Result 1: Government health facilities in Shangla are rehabilitated and equipped and are provided with sufficient medicines: DHQ and 3 BHU s have 90% availability of medicines as per WHO standard in the health facilities for distributions during consultations. Cordaid used a standard list of essential medicines provided by WHO and ensured that these drugs were at a minimum 90% availability at all times in the DHQ and the BHU s supported in the programme. All MoH health staff has been trained in improved drugs management. BHU s have been renovated and supplied with medical equipment. Four BHU s were rehabilitated. As the MoH had received funds to carry out rehabilitation work on health infrastructure, only minor repairs needed to be done by Cordaid. Cordaid renovated water supplies, provided additional shelters to be used as labor/delivery rooms (Amnovi and Shalizara clinics) and fully equipped the facilities. Shahpur clinic, where the existing structure was beyond use after the floods, Cordaid rented an alternative building which was set up as a temporary clinic. All 4 BHU s have been provided with appropriate equipment and furniture. Electricity in the DHQ is available 24/7, to be provided by Hydro Generator Work began in late August 2011 and was finished by early October. The hydro generator is fully functional and handed over to the Hospital end October 2011. Result 2: Increased capacities of government health staff and health institution to provide quality health care services. Medical teams consist of 1 medical doctor and 1 dispenser. All Medical teams were in place consisting of a doctor and a dispenser. Cordaid provided health care services to the population through the seconded ministry of health staff as well as Cordaid contracted staff. Services were delivered in static and mobile sites. During the project there were 6 medical doctors and 8 dispensers working for Cordaid in 6 medical teams. 3 Source: Final Report Emergency Health Response in support of the flood affected population of Shangla. Reporting period 01/08/2010 31/10/2011 15
The health staffs are trained on the provision of quality services. A total of 9 formal trainings and several on job trainings were conducted for various heath cadres for both MoH of health and Cordaid hired staff, where 109 health staff members benefitted. Cordaid also supported the midwifery school. The trainings included: - Introductory H&H, -DEWS and outbreak alerts, -Diarrhoea management, - Health care waste management, - Leishmaniasis, - Standard treatment protocol and rationale drug use, - Rational drug use, - DHIS management, - and MNCH training for LHVs. A Health management information person (DHIS) is trained in compiling daily and monthly DEWS reports and collects relevant health data. A DHIS coordinator was recruited who worked to build the capacity of the MoH in health information system management and trained facility based staff in accurate data entry in the required reporting formats. On the closure of Cordaid s Health Programme a DHIS coordinator was recruited by MoH who was trained by Cordaid DHIS coordinator and took over the responsibilities to sustain the DHIS system in the future. Result 3: Mobile Medical Units (MMU) are complementing the governmental clinic services in remote areas by conducting medical camps. MMUs have medical camps in remote areas at least 2/week/MMU. The MMU concept was developed to support Government efforts to provide healthcare in remote areas. Cordaid created 3 MMUs operating in 3 Union Councils, in locations where there was no healthcare available. The health camps were operated 3 times every week initially but in Shahpur the services went on to 5 days a week making the facility comparable to a static facility in terms of healthcare provision. The MMU teams were able to conduct 278 out of the 331 camps planned seeing a total of 42,304 patients since August 2010 to October 2011. Medical Teams give 7,000 consultations per month to flood affected people Cordaid health programme targeted 70, 000 people to utilize the health facilities and mobile camps and participate in the health awareness sessions. There were 93,566 consultations carried out in the implementation period (August 2010 to October 2011). Female consultation was 44754 (48 %) Male 48812 (52.17%) and Children < 5 years: 20551 accounting for 22% of the general consultations of patients seen in the facilities. Result 4: Communities demonstrate improved/increased awareness on basic health and hygiene. 7000 community members have received health education sessions through the health facilities Facility based health and hygiene sessions were conducted in the morning when patients wait at the triage area. These sessions were carried out by the medical doctor to each male participant and by the LHV (Lady Health Visitor) to female participants. In total 501 health education sessions were conducted, with a total of 10,678 community members reached. Students in 10 schools have received health & hygiene sessions. 28 Health and Hygiene sessions were conducted in various schools by a team of community health promoters employed by Cordaid and those working with CAVISH. Health committees are actively involved in the implementation of the basic health & hygiene part of the project and socially support the health structures in the community. At the 4 BHU s community health committees (CHC s) were established. Thus the Cordaid health facilities had in place community health committees which met periodically. 80% of 7,000 community members / families can give examples of health & hygiene problems and how to solve or prevent these problems. A study was conducted in July and August 2011 to assess the knowledge of the people on hygiene practices. It emerged that 78 % of population knew about the common health problems and acknowledged that good personal hygiene can prevent diseases like diarrhoea. More than 16
73% of the population understood that unclean water can cause diseases. In accessing the knowledge of the respondents on the causes of diarrhoea, 73.1% gave their answer as unclean water, 51.3% unsafe food, 33.3% indicated flies as cause of diarrhoea, 63.5% dirty hands, 20.6% bacteria and 6.4 % did not had any idea of the causes of diarrhoea. Result 5: Improve the health status of Leishmaniasis affected people in UC Jatkool of District Shangla. For two consecutive years Leishmaniasis outbreaks had been reported from the same area of Shangla District. After the Leishmaniasis outbreak that occurred in May 2011, the Cordaid health team provide curative and preventive intervention in the Jatkool area. In collaboration with WHO and the district MoH Cordaid sent out a team of a medical doctor and dispenser to the area. Medicines were provided by WHO. In addition mosquito nets were distributed (2650 in Jatkol area) as well as hygiene kits and hygiene sessions conducted. To combat the disease a vector control methodology was used, through spraying insecticide. Further Observations The evaluation team had meetings with the PM Health in Islamabad, the PC for Shangla district, the Senior Medical Officer and the female Gynaecologist of DHQ s in Alpuri and the District Coordination Officer (Administration) of Shangla. We visited also one BHU of Shahpur where we interviewed the medical doctor and had meetings in three villages with groups of men and women. All senior officials appreciated the Cordaid health programme. They expected that especially the hardware provided to the DHQ and the BHU s would have a lasting impact. In particular the installation of the hydropower station at the DHQ was valued, but also the medical equipment and furniture provided to the DHQ and the BHU s. In addition the curative care provided during the project period was highly appreciated, including the assistance provided during the Leishmaniasis outbreak. A lasting impact was expected from the establishment of the DHIS. The MoH had recruited a new coordinator and it was observed in the DHQ as well as in the BHU which we visited that the data were collected and entered in the database. Regarding the sustainability of the components related to the capacity building and institutional strengthening of the health services, the answers were less explicit. Recruitment and motivation of staff and proper support of the health facilities after the project period were beyond their control. During our visits to the DHQ and the BHU Shahpur we observed that not all equipment and the extra facilities provided by Cordaid were fully used. In the DHQ, furniture and teaching equipment for the midwife school was still stocked awaiting new funding for the start of the school. The equipment of the delivery room was not used because, as it was revealed, they needed the technical skills and the required number of staff as well as the required space to make it fully functional. The two extra shelters constructed at the BHU for a delivery room and as a working place for the LHV were still empty and the equipment for the delivery room unused. It was explained by the medical that, as they were not yet connected, there was still no water and electricity available for the new shelters. The local NGO Cavish was recruited to provide support for community mobilisation and the establishment of the community health committees (CHC s). CHC s were established at the 4 BHU s which were included in the health programme. We received a project completion report from Cavish (January 2010 July 31 st 2011) 4. The report contains information on the activities undertaken and project outputs but not on any achievements at outcome level. We asked the doctor of the BHU Sharpur on the functioning of the CHC. They should have assisted in organising the (small) works to be done to connect the shelters to electrical and water supply. All he had to say was The CHC 4 We had an interview with a representative of Cavish in Islamabad, but he had joined the organisation just two weeks before, so he couldn t inform us about the health programme. The Cavish sub-office in Shangla district was closed after termination of the contract. 17
members come, discuss the problems and go back. Based on these observations we have strong doubts about the achievements regarding the establishment and proper functioning of the CHC s. We will discuss the results of the hygiene promotion under the WASH programme. It appeared that more of the participants in the group meetings in the villages had participated in hygiene sessions organised by the WASH team, which also conducted these sessions in the 80 villages where they had rehabilitated the water systems than at the promotions organised at the health facilities. 3.1.3 WASH programme According to the information we received from the Teshil Municipal Administration (TMA) of Shangla District, a total of 276 water supply schemes was damaged due to the Flood disaster of July 2010 with damages in the range of 10 20% to 40 80%. It was estimated that 90% of these schemes got repaired by different NGO s. Cordaid repaired in total 80 water schemes. Availability of clean uncontaminated water was a top priority for the beneficiaries. They used to have functioning water schemes connected to their houses. After these schemes got damaged women (and sometimes men) had to fetch water from the river or other far away and sometimes contaminated sources. In our meetings in the villages water schemes were classified by many of the participants as priority no. 1 even before shelter. Cordaid provided material and technical support but the communities organised the actual works by themselves, for which they were paid after they finished each of the three stages in which the work had been subdivided (catchment and distribution tanks, main pipeline, the tertiary pipelines). For the work on the tertiary pipelines they were not paid. The level of participation from the communities involved was qualified as outstanding, which is also indicative for the importance they gave to the project. First funding for the WASH project was received from UNICEF (Phase 1: 50 water systems). The starting date of the project was 27 th of August 2010 with a project duration of three months. Because of changes in the initial project proposal (among others oriented on emergency water supply which was not needed) and delays in the project implementation an extension of the project was accorded until end of February 2011 and later on a second extension was awarded till March 15 th. Actual implementation of the repair of the water schemes started in October/ November 2010. The second phase of the programme consisted of the rehabilitation of 30 schemes funded by Cordaid. This phase was started after Phase 1 was done and was finalized in September 2011. Programme Effectiveness 5 All objectives, in terms of outputs (and activities), as defined in the project proposal have been achieved, but with delays. The specific objective of the project was to ensure access to sufficient clean drinking water and appropriate sanitation and enable good hygiene practice for people affected by the floods. Result 1. 3,000 flood- affected households or 21,000 persons in Shangla have access to sufficient supply of clean drinking water as per Sphere guidelines and UNICEF core commitments for children. 300,000 aqua tabs water purification tablets were distributed and in used by households. 80 community water supply systems were repaired and disinfected and operational, providing clean drinking water to 24,311 flood affected persons (3,473 HH at 7 pphh). 5 Source: Final Report Emergency to 2010 Monsoon Floods Shangla KP. Reporting period 01/08/2010 31/10/2011 18
Result 2: 6,000 flood- affected households or 42,000 persons in Shangla are reached with appropriate essential public health messages and sensitized on how to adopt good hygiene practices 6,000 hygiene kits and 6,000 jerry cans were distributed, reaching 42,000 people in 5 U/Cs. 175 hygiene awareness sessions were held, reaching and sensitizing 10,749 persons (flood affected) on appropriate essential health and the means to adopt good hygiene practice. 34 hygiene awareness sessions were held for 2,252 students in various schools on appropriate essential health and the means to adopt good hygiene practice. Further observations. In the meetings we had in the villages men and women could recall the main messages from the hygiene promotion. Typical answers on our questions of what they recalled, were: Keep drinking water covered. Keep your food covered to save it from flies and germs. Wash your hands before eating and after using the toilet. We learnt eat less but eat clean. Children suffered from diarrhoea frequently before but now we give boiled water to small children, due to this diarrhoea is reduced now However, it was observed that many washrooms were not clean and there was no water and soap in it. Many children were seen in unhygienic condition. We conclude that hygiene sessions have been useful. However, it takes time for the people to change their habits. Changing of the behaviour needs long term interventions with on-going monitoring and support. According to the senior engineer of TMA no handing over certificates of the water schemes had been signed, which officially is required and demands a visit of an TMA engineer to the water system to inspect the quality of the works. But also other NGO s had not yet done so. In practice the water schemes will have to be maintained by the village communities. Considering the importance which they give to the water availability and their high participation in the rehabilitation works, it might be expected that they will do so. The quality of the rehabilitation works of the waters schemes seems to be good. No complaints were heard from the beneficiaries neither the authorities. 3.1.4 Shelter programme Also the shelter projects achieved its objectives in terms of outputs to be delivered. But there were doubts about the timeliness of the intervention. There were great delays in the start-up of the programme and later on in the execution of the project. Several times the deadline for finalisation of the project had to be adjusted. Finally the project was completed at the end of November 2011. The rapid needs assessment done in early August 2010 identified shelter as one of the priority needs. But no proper follow-up had been given until October when the programme officer for Pakistan from HQ s visited the programme. It was decided to use the shelter design of the CRS shelter as the basic design but to adjust it to provide a more durable solution, i.e. semi-permanent housing. A reassessment was done of the shelter needs in the Shangla district by Cavish also taking into consideration the Union Councils already covered by the shelter project of CRS. On the basis of this assessment the number of shelters to be constructed was reduced from 1000 to 750. Further delay in writing the project proposal was due to the long time it took to have a final agreement on the precise shelter design and the BoQ (Bill of Quantities), which were prepared by the Acting Head of Mission who was an architect. The project proposal was submitted and approved in November 2010. The local Shelter project team was recruited in December and they started in January with a more precise assessment of the beneficiaries in the villages which were included for Phase 1 of the 19
programme. New Project Facilitation Committees (PFC s) were formed or they made use of the PFC s which were already formed by the WASH programme. Actual construction of new shelters started at the end of March 2011. It was explained that a major reason for the delay were problems with the suppliers. A first supplier couldn t satisfy the demand, after which a second supplier had to be searched for. Problems with suppliers, timely deliveries and supplies of all components of the shelter packages, were a major reason for delays throughout the implementation of the programme. Except a decline in the production in the months July and August, explained by serious problems in the delivery of supplies (July) and on the occasion of Ramadan (August), the construction of new shelters proceeded at a regular pace. But because of the late start of the programme, for example at the end of August 2011 only 507 shelters had been constructed against the target of 750 shelters, the Shelter team had to work under great time pressure all along the implementation period of the programme. Figure 1. Data on construction and deliveries of the Shelter programme During the initial assessment phase of the programme (August October 2010) there have been coordination problems with CRS, also implementing a large shelter programme (832 HH s) in Shangla district. The Head of Office of CRS in Shangla told us that he was surprised when he heard in October that Cordaid also planned to construct shelters and that he had opposed it. CRS had already done the identification of beneficiaries in 9 UC s and feared duplication. At field level in Shangla the two organisations were both claiming rights on UC s for the implementation of their shelter project. It was solved when the matter was brought at the level of the field offices at national level but the country director of CRS acknowledged that this was done too late. At national level it was decided that one of the UC s (Kuzkana) would be handed over to Cordaid while in the UC Shahpur it would take the villages where CRS hadn t yet conducted the registration of beneficiaries. Once this matter was settled coordination between the two organisations posed no more problems although at field level a certain animosity could still be felt. The project staff faced many problems in the selection process of the beneficiaries for the shelter programme. At first the PFC s were asked to establish a list of beneficiaries eligible for the programme. It was found that many of the beneficiaries on those lists were not matching the criteria. A first check of the lists was done at the field office by the staff, including the social mobilizers who were recruited from the UC s. On the basis of their knowledge of the communities a first reassessment was done. Approx. 20% of the names on the lists (total: 2532 HH s) could be removed in 20
this phase because they were clearly not eligible (examples: two brothers from a same family, families from neighbouring villages, families with minor damages of their houses). Thereafter a second assessment was done in the villages by the staff of the Shelter team accompanied by members of the PFC s. A total of 1995 families from the beneficiaries lists were assessed at this phase of which 723 HH s were finally found to be qualified as per the criteria of the programme. We concluded from the discussions with the project coordinator and the M&E officer of Cordaid that the assessments process was done thoroughly although it was a time consuming and difficult process. Meetings were organised in each of the villages to explain once more the criteria. In case of complaints the project coordinator himself went back to the villages to discuss the matter within the community. But complaints about the selection procedure continued resulting in letters to the DCO (District Coordination Officer) which were investigated, two court cases, threats of the local staff and accusations of bribery which were also investigated and found to be unjustified. In one of our village meetings a group of persons with complaints and accusations turned up. After the meeting we visited ourselves the house of one of the persons declaring that he was eligible but had not been selected, and a house of a family that was accused of paying bribery to get selected. In both cases we found that the selection criteria had been properly applied. A main problem in the selection process was the establishment of the beneficiary lists by the PFC s. It proved to be very difficult for the members of the PFC s to withstand social pressure and to exclude families which were not eligible. Later on in the programme, which was implemented in five phases each time starting with the assessment process in the new villages, it was decided not to ask anymore the PFC s to establish the list of beneficiaries. Instead the process started right away with the assessment at village level by Cordaid s project staff assisted by the members of the PFC s. It was said this made it easier and reduced the number of complaints. In the interview with the CRS head of office we found out that they had followed this procedure from the start of their shelter programme, based on lessons learned from the shelter programme after the earth quake where they faced the same problems, i.e. village committees who couldn t withstand social pressure. Cordaid had classified the potential beneficiaries in two groups, Category A and B. Category A criteria were: - a flood/rains affected HH a with fully damaged house owned by them; - beneficiary used the damaged house as his first home / not as commercial property; - should be a married person with a normal family structure; widows and widowers with unmarried sons or daughters qualified also; - he/she did not rebuild their house and was not covered by another NGO for provision of shelter, - was living with a host family or in a rented house; - had either own or donated safe and stable piece of land to build shelter. Category B criteria covered groups which were considered less urgent: - a flood/rains affected HH with partially damaged house. HH s who hadn t lost their house but were living in unsafe shelter due to land settlement/weak structures were also eligible; - a flood affected HH who was already covered by another NGO but the received shelter was not enough for this family considering its size and social norms (for example if a couple having young or mature kids are sharing single room or shelter or young brothers and sisters are sharing single room etc.); - a family who had migrated after floods due to house damages and now wanted to come back; - a person (married) who had a partially damaged house but was not able to repair it due to certain reasons, for example widows and disabled persons. Cordaid started the shelter programme for the Category A beneficiaries but after their needs were fulfilled included also Category B beneficiaries. The criteria for Category B were less unambiguous compared to the Category A criteria and therefore the selection process was more at risk to be contested by non-beneficiaries. At the end of the programme it became difficult to identify enough beneficiaries eligible in the original area of operation (4 UC s). In order to solve this and in order to construct all 750 shelters and latrines, as initially planned, Cordaid increased the geographical area by including one more UC 21
(Damorai) that was affected by the floods and where CRS had already built transitional shelter. Here 134 houses were built in the last phase of the programme (many of them Category B beneficiaries) In addition 23 shelters were built at the premises of schools to be used as additional class rooms and 4 shelters were built at BHU s to expand their facilities instead of building more shelters for HH s. There were doubts among the project staff about the relevance of the programme as an emergency response especially in its later phases. Many of the beneficiaries especially the less vulnerable, also those belonging to the Category A, managed quite well having found shelter either by renting or staying in a relative s house. Through inclusion of Category B beneficiaries many social cases could be assisted but the real urgent cases were already assisted 6. Apparently the needs assessment had overestimated the needs (the figure shifted from 1200 HH s in August 2010 to 1000 HH s and later 750 HH s in October) or had not taken sufficiently into account the shelter programme of CRS. It was said that also the late implementation of the programme had implications. The urgency right after the floods was not felt anymore and people began to play a game just to benefit of free hand-outs. In the village meetings, on the question whether the beneficiaries preferred the shelters of good quality as built by Cordaid or would have preferred lower quality houses as built by other agencies but built in time (before, during or just after the winter), the answer was that they choose for the houses of Cordaid although they were built late. But in a CRS settlement occupied by beneficiaries which all came from a village (130 houses, mosque, school) that was completely washed away, the beneficiaries choose for the CRS houses. They were delivered in time when they lived in dire conditions in overcrowded houses of host families or even under plastic sheets in the mountains. We conclude that the programme was relevant but the response should have been timelier and the number of shelters should have been smaller. In the end the target of 750 shelters became an overriding goal casting doubts on the relevance of the programme in its later phases 7. The decision to substitute some shelters for the extension of schools and BHU s was certainly a right one. The houses were of good quality, well insulated, and the beneficiaries were mostly extremely happy with them. But critical remarks were made regarding the appropriateness of the shelter especially among the women. All the women interviewed highly appreciated Cordaid s shelters. It was a primary need as their houses were destroyed by the flood. The women said that the shelters were strong and also big enough to accommodate a small sized family. However the shelter did not include a kitchen and the women were in a dire need of it. Also, the latrine is not attached with the shelter which raised the question of protection and privacy for them. The shelter does not provide aman (privacy and security), latrines are not attached and we feel exposed. There is no separate kitchen with the shelter, I cook in the shelter Conclusion: The quality of the shelter is good but the design of the shelter has to be culturally appropriate to ensure safety and privacy for women. Also, there should be provision of a kitchen with the shelter to facilitate women 8. Programme effectiveness 9 All objectives, in terms of outputs, as defined in the project proposal have been achieved, but with major delays. 6 The project coordinator estimated that 40% of all beneficiaries belonged to Category B and 60% to Category A 7 The materials for the last 700 shelters had also been ordered all in once. This restrained the flexibility of the project for an adjustment of the output targets as it required renegotiation of the contract with the supplier. 8 There have been discussions on the construction of a kitchen and of the latrine directly adjacent to the shelter. Construction of the kitchen was rejected for budgetary reasons, and of the latrine for sanitary reasons. 9 Final report Pakistan, Shelter & WASH Rehabilitation Shangla (2010 floods). Reporting period 01/08/2010 30/11/2011 22
Specific objective: 750 Disaster-Affected Households in Shangla District live in appropriate semipermanent shelters and use latrines. Result 1&2: 750 households have constructed semi-permanent shelters and household latrines 723 semi-permanent shelters with proper insulation are constructed. 723 latrines have been constructed alongside shelters. A Post Occupation Evaluation was conducted by the M&E section in October / November 2011 among 83 beneficiaries. Results show that, while 43% of the beneficiaries didn t have a latrine before, by now 90% of them say that they use the latrines. 23 classrooms have been constructed on school premises in flood-affected villages 4 rooms for different functions (waiting room, delivery room, OPD treatment room) have been constructed on BHU premises in flood-affected villages Result 3: Beneficiaries, skilled and unskilled construction, masonry and carpentry workers have increased capacity to construct semi-permanent houses and community PFCs are actively involved in the implementation of the project. 236 skilled and unskilled workers have received vocational training in construction masonry and carpentry. They were able to construct semi-permanent shelters and identify critical points in construction 66 PFCs were involved in the facilitation of the shelter construction project, particularly through the assessment process of beneficiaries, the monitoring of progress and the containment of conflict 3.2 Cordaid s shelter programme in Kohat Because of the tight time schedule the evaluation team couldn t visit Kohat district. So, we depend for our assessment of the programme on the information collected in the interviews with the senior programme and administrative staff of Cordaid Islamabad, the PM for Kohat - who had joined the programme in August 2011 -, and the meeting we had with local staff of the Shelter team of Kohat. Cordaid also implemented a Health and a WASH project for IDP s in Kohat district alongside the Shelter programme. The first project was not included in our assessment as they were not part of the Flood Response Programme. As funding was not fully utilised in the Health and Wash programmes in Shangla, it was decided at the end of 2010 to propose also a shelter programme in Kohat. In August 2010, Cavish had already done a rapid assessment in Kohat; the region was then qualified as mildly affected by the floods. In December/January a reassessment was done by Cavish and local Cordaid staff. Two more UC s were included in the programme as the re-assessment showed that the project budget would not be completely utilized in the three UC s which were initially selected. The results of the detailed assessment in the 5 UC s indicated that 77 houses were damaged beyond economical repair, 115 houses needed major repairs and 15 houses minor repairs. In the final proposal, submitted in January 2011, construction of 60 new shelters and repair of 110 houses with major damage and 15 houses with minor damage was planned. A senior engineer was recruited end of December 2010 and a project officer end of January 2011. However, the project experienced major delays with as a result that the construction works didn t start until August 2011. A major effort has been made since then resulting in completion of the project in November 2011. Reasons for the long delays were among others: End of January the project started up. Repairs of the houses required individual designs and calculations of the materials needed for each house, what took two months. 23
In April, there were serious problems with one of the social mobilizers who threatened the other staff, set some of its local comrades up against Cordaid and accused Cordaid in a local newspaper. He was one of the first staff members recruited by the project and, belonging to an influential family, felt passed by when the junior engineer got the position of project officer. It was said that these tensions caused major delays throughout April and May. In June, the tender for material supplies for the 60 new houses had to be renegotiated since a delivery schedule has not been appended to the contract. The new houses had to be constructed on safe locations in view of the risks of future floods. The beneficiaries had to obtain new land and legal documentation. In July, it appeared that proof of land ownership had stalled. In July, the tender for the 125 houses to be rehabilitated was in process. First building materials were delivered in August. Kohat as well as Shangla had UN security level 4. It means that UN staff was not allowed to go into these regions. INGO s often make their own decisions based on their assessment and knowledge of the local situation. The government didn t give a permit, an NOC (Non Objection Certificate), allowing international staff to stay overnight in Kohat District. Day trips were allowed but no field visits. In Shangla district permission was given to stay overnight in Besham, where the shelter/wash team had its office. Thus both in Shangla and Kohat, expatriate staff could not be stationed on location. Monitoring of the projects was done through regular (weekly / biweekly) visits to the districts. But while in Shangla expatriate staff could stay overnight, in Kohat the expat staff had to return on the same day to Islamabad and could not visit the field. It means that the expat staff could spend at maximum 4 hours at location and only at the field office. Such conditions require good project management, a very competent team of local staff and proper monitoring tools adapted for remote monitoring. It appears that the local project manager was not strong enough to properly guide the programme, to solve problems and to manage his team. Also the monitoring system required was micro management by the PM (expat), proper tracking sheets etc. to be able to control the process appeared to have major defaults. The last PM, employed in August, installed a GPS system with cameras on the building sites to be able to check the progress of the works. And he had the good fortune that the former M&E officer resigned in August and he could recruit a new one who performed very well and really controlled the works. The Head of Programmes and the PM for Kohat, both employed since August 2011, of Cordaid had major doubts about the relevance of the shelter project. Especially the repairs on the houses were considered as beyond what was normally done in an emergency response programme 10. All construction and rehabilitation works, i.e. 60 new shelters and repair of 110 houses with major damage and 15 houses with minor damage, were completed at the end of November 2011. 3.3 CRS Programme Sindh CRS has worked in Pakistan for more than 50 years in development and disaster response programmes. It responded in 2009 to the IDP crisis in Swat Valley, to the October 2008 earthquake in Ziarat (Baluchistan), the July 2007 Flood Response in Turbat (Baluchistan), the October 2005 earthquake in KPK and AJK. It has a well established country office in Islamabad and can draw on human resources and expertise from its regional office in Asia. Lessons learned from previous working experiences in Pakistan (and worldwide) can be incorporated in new emergency response programmes and local staff working elsewhere in Pakistan for CRS could be transferred to Sindh. 10 HQ s also raised doubts, in April / May 2011, whether the shelter project should still be executed because of its late start. But at that time the Field Office insisted on its realisation. 24
It was found that the programme in Sind was very well structured, from the early phase of the needs assessments and programme design to the actual phase of programme implementation. Four needs assessments were conducted, a rapid assessment of nearby areas of Sindh in mid-august, a rapid assessment of Jacobabad in late September, a WASH assessment in Jacobabad in October, and a seed assessment in Sindh in September. The assessments were conducted by experts from the regional and national offices in collaboration with the local staff of CRS in Sindh and its partner organisations. The needs assessments were of good quality looking for appropriate solutions and programme design adapted to the situation and cultural context. The project interventions of CRS were timely done. In the two villages we visited people returned to their villages in October / November. Immediate repairs of the damaged hand pumps had been done. NFI s distributions took place from November in conjunction with the distribution of shelter materials. In both villages the beneficiaries had received seeds (cash & voucher) for the Rabi season which had been distributed in time. They had received transitional shelter (not funded by Cordaid) in January/February respectively February/March. The last phase of the programme consisted of the construction of new water systems executed in June/July. Rehabilitation of the irrigation infrastructure (cash for work) was done in June, just in time for the Kharif season. The local senior staff we met at the sub-office in Jacobabad District had all previous experience in disaster response programmes of CRS. For example the Program Manager Agri/Livelihoods had worked in voucher and grant programmes implemented by CRS in response to the IDP crisis in Swat Valley in 2009 and 2010. The Programme Managers WASH (expat) and Shelter had worked before for CRS disaster response programmes respectively in Sudan and elsewhere in Pakistan. CRS implemented the programmes in collaboration with three local partner organisations, namely GSF (livelihood, WASH), RDF (livelihood, shelter) and YAP (shelter, WASH). For their partnership an on the job-training model has been developed. For all programme components (shelter, WASH, livelihood) 65 70% of the total staff was employed by the partners and 30 35% was employed by CRS. CRS provided the project officers/project managers and the partners recruited the field officers. The staff of the partner organisations received short trainings on M&E and a project orientation training. During the implementation phase each week started with a planning session for the field activities. Initially the CRS project officer and the field officers of the partner organisations went together into the field until the field staff could be entrusted to work more independently. CRS Programme Managers visited the offices of the partner organisation almost daily to coordinate and exchange experiences and information. The partner organisations which we met (GSF in Sindh; ROAD in Shangla) appreciated the approach. They missed the experience in emergency response programmes and didn t have the capacity to implement programmes on this scale. It was a good learning experience and they felt that they had strengthened their capacity to implement in future such type of programmes by themselves. CRS Pakistan developed this partnership approach recently. In development programmes CRS normally mostly works with local partner organisations as implementing partners. But after the earthquake of 2005 CRS didn t have the time to select partners and implemented the projects itself. Thereafter it was decided that also in emergencies CRS should try to develop the capacity of partners. Since partners lack the technical expertise neither have the capacity to implement large scale emergency response programmes this particular approach was developed. Gradually responsibility is handed over to the partners. For institutional strengthening of the organisations in Sindh the partners also received trainings in M&E, human resources and financial management. The CRS coordinator for partnerships in Islamabad said that the partners also receive training in strategic planning. CRS aims at developing strategic partnerships with the partners. GSF in Sindh will continue the partnership with CRS in the next phase of the programme. CRS followed an integrated approach to ensure the programme had a real impact and the victims of the flood were properly assisted enabling them to recover from the floods. They were assisted with 25
NFI s, shelter, water and the cash & voucher agricultural programme. We also concluded that the assistance had a large impact in the villages covered by the programme but at the same time one can observe neighbouring villages which have received little assistance. According to the DOC of Jacobabad approx. 40% of the flood victims hadn t received yet any adequate shelter assistance. This can create resentment and conflicts. According to the country director of CRS it had also been decided therefore reason after the floods of 2011 (Sindh) that CRS would spread out its assistance over a larger area instead of concentrating on fewer villages. Also the cash & voucher programme provided for seeds and inputs only for 1 2 acre while an average famer cultivated 7-1 2 acres, thus assuring a larger coverage. The villagers whom we met prioritised the construction of the new water systems as the intervention that they had appreciated most. Next to water, shelter and the cash & voucher system were appreciated almost equally. Also all beneficiary women much appreciated the water schemes. It has made their lives easier. The supply of clean drinking water to the door steps has reduced their work burden. Also, the quality of the water is considered to be good. That may result in reducing the water born diseases. As the women said: We used to carry water from faraway places. We get exhausted and our heads had wounds for carrying water persistently. We thank you for the gift. There is one hand-pump for eight households; the water is enough for us. Before this water, we had many skin diseases but no itchy skin now. CRS has spent a considerable amount of time on community hygiene session five weeks per village. All the women (and men) in focus group discussions recalled the hygiene sessions as follows: Keep drinking water covered. Wash hands with soap after using toilet. Keep animal shelters clean. Clean your teeth with dentonic or neem miswalk (the twig of neem tree). Now diarrhoea and malaria have reduced because of cleanliness Hygiene practices such as use of soap, clean surroundings and tidy shelters were observed in the village that had received a new water system and thus also benefited of the five weeks hygiene promotion sessions, in contrast to a next village that we visited where the people had not benefited of hygiene sessions (only emergency repair of hand pumps had been done). We conclude that hygiene promotion sessions combined with the supply of clean drinking water has made a significant difference in promoting the good hygiene practices among some of the beneficiary communities. Programme effectiveness 11 Objective 1: Targeted families have access to non-food items to meet their immediate hygiene and shelter needs. 2650 NFI / hygiene kits containing a plastic woven sleeping mat, plastic bucket, mosquito net, bamboo for the mosquito net, a jerry can, cotton cloth, towel, nail clipper, lota 12, polyester rope, body soap, and laundry soap were distributed. At each of the 78 distribution sites, NFI/Shelter staff conducted trainings with beneficiaries to teach them how to properly use the items they received in their kits. Objective 2: Flood-affected households have sufficient quantities of clean water to meet their essential household needs. With Cordaid funding, CRS reached 27 villages in two Union Councils in District Jacobabad with water supply scheme interventions, including boreholes, new hand pumps, new pipelines, and water storage tanks/reservoirs 382 hygiene promotion sessions for men and women, on use of clean water, safe excreta disposal and hand washing. The sessions took place over a period of five weeks per village. 11 Source: CRS Final report to Cordaid. 12 Used for personal sanitation. 26
Objective 3: Flood-affected farming households have resumed farming. In the Rabi season, 259 beneficiaries received vouchers to be redeemed for wheat seed, fertilizer and vegetable seed, with a total value of 176 USD. In addition they received a cash grant of 50 USD for the cultivation costs of tractor rental. In the Kharif season, 3492 beneficiaries were assisted. Four commodity packages were offered out of which the beneficiaries could choose. The packages cost were on of average of 213 USD. The amount of the cash grant was increased to 95 USD in anticipation of the needs for fuel for pumping water from the tube wells as the primary crop for Kharif season is rice. In addition a cash-for-work program was started to rehabilitate irrigation schemes (45) and one link road. 46 CfW schemes were completed, taking on average 5-8 days, in which 1033 individuals were hired. Objective 4: Flood-affected households live in locally-appropriate shelters that provide the basis for disaster recovery. The project provided 10,000 plastic sheets, which made possible the construction of 2,500 transitional shelters, using 4 sheets per shelter. 3.4 CRS Latrines project in Shangla, Kohistan, Swat districts. CRS started its shelter/latrine project in early October 2010 with the construction of a demonstration shelter, in the presence of the regional advisor for shelter. He assisted the Shelter team in the final design. Construction of the shelters/ latrines started in November prioritising first the HH s whose houses and land had been completely washed away. By January 2011, materials for 1,514 latrines and bathing spaces had been distributed. By this time, 995 households had built their shelter and latrine, 43% of the final project target of 2300. End of March 2011 all shelters / latrines had been constructed in Shangla district while the entire project was completed at the end of June 2011. Latrines/ bath space have been built directly adjoined with the shelters. The women were happy about the provision of the latrines adjacent to the shelter as it ensured their safety and privacy. Running water was available in the latrines. CRS has sensitized male beneficiaries on the importance of hygiene in a short session at the distribution site of the shelter materials when they came there to collect these. The men were instructed to educate their wives and families to ensure the family hygiene. In the village that we visited this seemed to have worked quite well as was evident from the cleanliness of the shelters and the latrines. The men said they had passed the information to their wives. CRS worked with local partners ISWDO (Indus Social Welfare Organization) based in Kohistan, ROAD (Rural Organization for Awareness and Development) based in Shangla, and LASOONA based in Swat. With ROAD the same system of on the job training was practiced as explained above for CRS-Sind. Also they were satisfied with this approach. ROAD will continue to work with CRS in an agricultural livelihood programme. ISWDO had already worked before with CRS in Kohistan. Their staff was working more independently for the implementation of the shelter programme. 3.5 ODP & TWO Programme ODP and TWO are partner organisations of Mensen met een Missie one of the constitutional member organisations of Cordaid. Immediately after the floods they collected funds and goods, food items and clothes, to assist the flood victims although at a modest scale. TWO organized also medical camps in two districts. To raise funding they contacted their donor organisations such as Mensen 27
met een Missie. The last one referred them to Cordaid. In first instance there were requests from six local partner organisations. Cordaid asked them to prepare a joint proposal as it would be too complicated to deal with several small proposals and organisations. Four of the partners got excluded because, as ODP said, they didn t have sufficient experience or were not from the area directly affected by the floods, thus lacking a proper network and knowledge of the area. The first proposal of the consortium of ODP & TWO was submitted at the end of August / early September. Discussions went on with Cordaid HQ s for further clarifications. The contract between Cordaid and the consortium was finally signed in the second half of October. Re-assessment of the needs and registration of the beneficiaries was done after signing of the contract. The distributions of NFI s, food packages and tents took place from Nov. 15 th till Dec. 17 th by ODP and Nov. 23 rd till Dec. 27 th by TWO. Four medical camps were organised by TWO between Dec. 12 th and Jan. 7 th. Part of the project was implemented by ODP through local NGO s which were active in the different districts, knew the social context well and had their local staff or volunteers working in the area. These local NGO s were only paid for their transport costs. They received one day training before the project started on assessment and distribution methods conducted by ODP. ODP monitored their activities. We visited two villages that were assisted by ODP, through their partners, and met with representatives of another village in the office of ODP. Due to our limited time we couldn t visit the field with TWO, but had a meeting with some of their staff members in the ODP office. The distribution of NFI s by ODP had been a blanket distribution. The distribution of the tents also, but because of the small number of tents available they were distributed per extended family. Each family, often consisting of several HH s, received one tent except those families whose houses were not destroyed. In the villages that we visited only (few) brick houses were not washed away. The distributions seemed well organised. Village committees were established including women. Each family received before the distribution a token and it was reported that the distributions proceeded in an orderly way. The beneficiaries stressed that the distributions were fairly done. Each HH entitled for the assistance had received it. Both TWO and ODP encouraged the women to collect the relief items personally, also to ensure that widows and female headed households got the support directly. As a result, many women came to the public places and distributions points, got an opportunity to interact with diverse people and had access to information. The beneficiaries said that the provision of the tents came at an appropriate time when they had recently returned to their villages and most people hadn t rebuilt their houses yet. At our visit some of the tents were still used as many families hadn t reconstructed their houses completely, i.e. the number of rooms was still too small to accommodate all family members. We had some doubts about the timeliness (and consequently the relevance) of the provision of food packages. In two villages the beneficiaries said that they hadn t received any assistance from any other organisation after their return, but one village had received food rations from WFP during a nine month period starting from December / January. ODP and particularly TWO seem to be well established organisations working in the fields of human (women) rights and peace building. Also the local NGO s that implemented a (large) part of the programme for ODP seemed well organised. But they had little (ODP) or no experience in emergency response programmes. Apparently this was one of the reasons that the assessment of the project proposal by Cordaid HO s took such long time. Local NGO s have a comparative advantage at the early phases of an emergency when the international organisations haven t arrived yet, or to reach isolated locations that are not assisted by the international agencies. At the moment that the project could finally be implemented (Nov. /Dec.) other organisations, such as WFP, had already arrived; duplication of assistance became a risk. Due to the large scale of the disaster and the limited response capacity of the national government and international agencies, apparently the assistance of ODP and TWO could still fill gaps, i.e. assist villages that were not served by other organisations. Their assistance was still relevant. 28
TWO hired a local consultant with expertise in emergency response programmes who assisted them in all phases of the programme - the project design, writing of the proposal, orientation training to the staff for the assessment process and organisation of the distribution, monitoring of the distribution. Cordaid didn t provide technical support to the partners. The M&E officer of Cordaid visited ODP & TWO in mid-october, but apparently this had more the character of a field visit. The financial administrator of Cordaid visited ODP in early November, mainly to explain Cordaid s financial reporting system. ODP received also emergency response funding from Misereor-Germany (Sept. Nov. 2010 and Febr. March 2011) and Norwegian Church Aid (Febr. March 2011). TWO received assistance from Diakonie Katastrophinhilfe (DKH). DKH provided training to TWO on the Code of Conduct, the distribution chain, project writing and disaster risk reduction. For a second phase, distribution of agricultural inputs, the project coordinator of DKH was a member of the procurement committee; he assisted in meetings with vendors and was present at distributions. At that moment DKH had established an office in Punjab (Multan). To facilitate the administrative work for Cordaid the partners were asked to submit a joint project proposal and to work as a consortium, in which ODP would be the lead agency, i.e. the direct contact for Cordaid HQ s and responsible for reporting. ODP was still in favour of this arrangement, saying that they did provide necessary support to TWO for revisions of the project proposal and through monitoring of their operations. TWO reported that the arrangement was burdensome and characterised by misleading instructions, lack of communication and unnecessary extra exercises instructed by the lead organization. Programme effectiveness 13 Overall objective: To launch an emergency response intervention for the relief and early recovery of 2500 flood affected families of 6 districts in Southern Punjab by providing them food ration, essential kitchen item, hygiene kits, emergency health assistance and tents. P 300 beneficiaries received tents and 700 beneficiaries received two monthly rations of food packages containing wheat flour, daal chana, sugar, salt, rice and tea (ODP). 1500 beneficiaries received a food package, NFIs and Health Hygiene kits (TWO). 4 medical camps were organised where 2430 patients were received (TWO). Photo 3: Tents distributed by ODP Photo 4: Women waiting for distribution of relief items 13 Source: Project Completion Report. November 2010 January 2011. Flood relief in flood struck areas in Punjab. 29