Category Archives: Blog

Waste collection

Behavior change and public participation is key to a functional waste management.

Waste is growing

Humanity have created 8.3 billion tons of plastics since large-scale production of the synthetic materials began in the early 1950s, and most of it now resides in landfills or the natural environment[1]. Globally, some 3.5 billion people lack access to formal waste management services and population from remote areas in Afghanistan is no exception.

Global plastic pollution numbers give headaches: 500 billion plastic bags are used each year, one million plastic bottles bought every minute; most plastics do not biodegrade, so the plastic waste humans have generated could remain for a hundred or several hundreds of years. More and more plastic waste is found in the Afghan landscape, even in such places that should deserve or have already the status of a national park. It is said that a dip in the lakes of Band-e-Amir, the first Afghan national park, will cure you from diseases, however the rubbish and waste that seems to end up in the lakes would suggest otherwise.

Community based initiative in Sokhtagi

Shocked by the amount of garbage littering the lakes, pounds and rivers of the region of Sokhtagi, Nai Qala’s president shared her sad feelings with the local community during her stay in the area, in March 2018. Her words positively resonated with the population who decided to take action. End of June 2018, the school council of Sokhtagi organized a general waste collection day where more than 350 people participated. Parents, school teachers and students gathered several dozens of kilos of plastic, glass, metal and fabric from the pound of Sokhtagi and its shores.

Such a motivation among the community of Sokhtagi, in an historically isolated region, is remarkable. Among many other benefits, the building of a school make villagers mindful of their environment. “We have one of the most beautiful lakes right in front of our door, we must take care of it and, who knows, one day our village will become an area to attract many outsiders to visit”said a gentleman who was among the cleaning volunteers.

Becoming aware of the environment and the generated waste 

Nai Qala promotes sustainability values and engages the community to be mindful of their environment and take care of the nature. Nai Qala encourages the community of all villages where it builds schools and health center, and ensures environment is discussed with the beneficiaries of its programs.

At a moment when the World Bank estimates that global solid waste generation is on pace to increase by 70 percent by 2025, with developing countries facing the greatest challenges, such community based initiatives give a strong signal of hope. Not only waste collections day but also a critical thinking about the material populations use as well as good waste management practices will help keep those remote regions of central Afghanistan clean. Let’s hope waste reduction and waste collection, being thoughtful about what one’s buy and choosing a sustainable option whenever possible will become part of the local culture.

[1]Roland Geyer et al. Production, use, and fate of all plastics ever made. Science Advances, July 2017 DOI: 10.1126/sciadv.1700782

Back-to-school season for 180 youngsters

While most children in the northern hemisphere are in the middle of their summer holidays, 180 young children aged 4 to 6 have started their first school year this July.

Preparation of equipment

Nai Qala’s president, Taiba Rahim, and the Kabul team have been  verybusy these past few weeks. Several hundred kilos of material were collected in Kabul to equip the classes.

Chairs, shelves, toy boxes, white boards but also carpets, all multiplied by 7, were sent to 7 villages in the mountainous regions of Ghazni (close to the schools of Sada, Ghow Murda and Nai Qala) .

In addition to furniture, large school supplies were also purchased and transported; these are, among others:

  • dozens of kilos of wooden blocks made for the occasion by local carpenters;
  • various toys, construction games, toy cars, dinette, balls and much more;
  • paper, cardboard, colored pencils, paint;
  • basic hygienic material such as soaps, toothbrushes and toothpaste.

Nai Qala’s team, represented by Mr. Qeyam and Mr. Ali Reza were involved  at 200% in classroom installation, not only in Kabul where they carefully organized all the logistics and where they ensured that the purchased equipment was properly packaged to withstand the surprises of transportation, sometimes on very bumpy roads, but also on the field. Mr. Qeyam spent a full month in the villages to make sure that all the material had arrived and was properly distributed, and that each class was well installed. Each village is separated by a distance of 20 minutes to 1 hour by car; to connect the first to the last village, it takes 4 hours.

Accelerated training for teachers

After a recruitment process to which 55 candidates applied, the Kabul team selected 9 young women. These are girls graduated from the first 3 schools built by Nai Qala, often single or sometimes already married, and who have a university (or other) degree. As employment opportunities in these remote areas are minimal, the creation of early childhood education classes opens up new opportunities for work.

Ms. Zewar, one of the two teachers of the early childhood education classes opened in 2017, took the responsibility to organize a 3-day workshop and give some new pedagogical bases to the new recruits. Ms. Zewar herself benefited from a one-week workshop, followed by another on the job, before teaching the little ones. For young women, the workshop was the first experience of its kind.

In addition to the 3-day workshop, Ms. Zewar will coach, on a day to day basis, the new teachers in their respective classes. She will travel to each village, accompanied by an experienced driver, to encourage, guide and support each of the teachers in their new experience.

During the training workshop, the young women discovered some teaching materials but were also able to familiarize themselves with games and various toys. This training was also an opportunity to experiment for the first time toys, which they had not access to when they were young. A moving discovery!

Involvement of the local community

The involvement of the local community is essential in the project. Each community has made available the best room in the village to create appropriate learning conditions. In some cases, if the rugs brought by Nai Qala did not cover all the floors, the villagers provided the carpet to cover the missing parts. The community is very committed to installing the equipment, participating in its unloading and unpacking.

Each village eagerly awaited the arrival of Mr. Qeyam; the whole community of men, women and children gathered together, ready to help with the transportation of equipment, stow the roadside with informative panel or arrange the classroom.

What is not visible

Setting up a project of this magnitude requires months of preparation. This represents  indeed many visits to the central and provincial ministries, and hours of negotiations with the villagers that were necessary to ensure the sustainability of the project. An agreement has been signed with the government to ensure monitoring beyond the first 3 years of the project; agreements with each local community have been concluded to ensure the availability of the premises where the courses will be delivered.

Each organization operating in the field of education must involve the Ministry of Education since it is the gate keeper of the national education plan. As a result, the government will monitor the progress of the project and make constructive suggestions. The Ministry of Education, through its provincial-level leadership, has committed to follow-up to ensure that the project works properly and is community based, and will manage the early childhood education classes in terms of human resources, after 2020.

Back to school

In total, 180 children participated in their first school year. The Nai Qala Early Childhood Education project reaches 9 classes in 9 villages: 7 new classes added to the 2 classes already initiated at the start of summer 2017.

The little ones, between 4 and 6 years old, will not only learn to read and write but also expand their imagination and develop through play and artistic activities. The early childhood education class is also an opportunity for these young children to socialize and learn some good manners and basic hygiene.

After a few days of classes, the feedback is already very positive. Parents say they have no problem waking their children early in the morning, which was not necessarily the case before the start of the school year. The inhabitants of the 9 villages are very happy and make sure that the program is going well. The teachers are super motivated and the joy is shown on the faces of the children.

To learn more about Nai Qala and early childhood education, it’s here.

Bamyan, province of hope and openness

A music festival as a symbol of emerging change

After all the horrors that took place in Bamyian, the city is fast becoming the musical center of Afghanistan. As a strong signal demonstrating the nonsense of the destruction of historical monuments, concerts are held right in front of the empty site of the Buddhas.

For the second consecutive year, Bamyian is hosting the dambora festival, a traditional 2-string guitar. The music festival is open to all beginners or confirmed musicians, boys, girls, old or young … and of course to the stars.

The festival takes place this year from June 29 to 30. Thousands of fans cheer on their favorite musicians and singers, and some even sketch a few dance steps. Bamyian province is the only one in Afghanistan where women go to concerts and can freely express their joy. The festival is a symbol of an emerging change that manifests itself in times of suffering and despair.

The dambora festival is happening in an area where Nai Qala has built 6 schools and has also contributed to positive change, especially women’s empowerment. The schools of Nai Qala are just beyond the mountains!

Nawur health center as a confirmed base for vaccination

Nawur health center is used as a platform for vaccination campaigns in the region

Afghanistan is one of the last three countries in the world where poliomyelitis is still endemic [1]. 14 polio cases were reported in 2017, and by the end of April 2018 there were 7 new cases reported in the country [2]. Polio mainly affects children under 5 years of age and one in 200 infections leads to irreversible paralysis.

Polio is one of only a limited number of diseases that can be eradicated and it can be eradicated because it affects only humans, because a cheap, safe and easy oral vaccine exists and immunity lasts a lifetime.

In March, the Afghanistan polio eradication initiative conducted its first national immunization campaign for eradication of the disease in 2018. In just a week, around 70,000 workers knocked on doors and stopped families in health centers, city streets and border crossings to vaccinate almost ten million children [3]. Monitoring data reflected more than 94% coverage in each vaccination campaign during 2017. The number of children missed due to inaccessibility went down since 2017 but an estimated 138 000 children were still missing in the national vaccination campaign of March 2018.

Without a clinic, a region like Nawur would have remained unknown to the health authorities; at its opening, the ministry of public health informed organizations such as UNICEF which registered the clinic as a vaccination center. The ministry and its partners have long been trying to reach isolated areas with vaccination campaigns and the health clinic gives them a base for this in the region. Before the establishment of Sar Assya clinic in the district of Nawur in 2011 [4], various illnesses remained untreated, the mortality rate among mothers and children was high, and children did not receive the requisite vaccinations. The Nawur clinic’s services have brought about significant improvements in the health situation of the population.

Since it registration in the national health care system, the Nawur clinic’s staff vaccinated thousands of children not only for polio, but other infectious diseases such as tuberculosis, diphtheria, tetanus, pertussis, etc. In 2017, 1,022 children and several hundreds of women were vaccinated in Nawur. During the March 2018 vaccination campaign, 142 young children received the polio vaccine.

Through its implementation in a remote region of central Afghanistan Nawur health center contributes to the reduction of mortality and serves as a base for vaccination and other prevention campaigns.

[1] http://moph.gov.af/en/page/polio-eradication/polio-situation-updates

[2] Note: No cases have been reported since 2016 in the central region of Afghanistan where Nai Qala operates.

[3] http://www.emro.who.int/afg/photo-essays/ten-million-children-70000-workers-five-days.html; http://www.emro.who.int/afg/programmes/polio-eradication-initiative.html

2011 – Sar Assya

Girls’ education, a change of mindset

Promoting girls’ education and cultural changes through a capacity building program

Improving the quality of education provided in the schools Nai Qala has built. 

Overall, the quality of education in Afghanistan in particular in the rural areas is very low. To remedy this, the Nai Qala Association is not only providing school buildings in those isolated regions but also several tutoring classes in sciences, and preparation courses to the national test for university entrance. Without such classes, many girls would not have taken the exam, as parents do not have the means and motivation to send them to towns to get private lessons.

The role of Nai Qala’s teacher training in capacity building is much more than transferring scientific knowledge.
Inspired by her experience with western school systems that promote regular communication between teachers and parents, Nai Qala’s president motivated the teacher-trainers to establish such a culture. Trainers meet parents to encourage them to be supportive at home with their children. In remote rural regions, many parents are illiterate and cannot help children with their homework but can support them by giving them space and believing in them.

The trainers are very aware of the importance of the role of parents in children’s education and have realized that such support was missing in their time at school. Nai Qala’s teacher-trainers even go to visit parents of those students who do not participate during class; they walk for a few hours to find an almost isolated house, in the mountains, with a tiny piece of land and a few heads of cattle. When parents first see the teachers they are a bit afraid, wondering what they want from them and why they are coming to their house. However when the teachers introduce themselves and explain that it is part of their role to meet the parents, not only because their child comes to the capacity building class but also to congratulate the parents for sending them to the course, many parents cannot believe what they hear and get emotional. Amazingly, the teachers very often see a different attitude in their student in the next days. This girl or boy comes earlier to school and interacts more, now being aware that their teachers give them importance.

Teachers take initiatives to triggers girls involvement at school.
Teachers discuss among themselves the participation and involvement of students in the class. They, for example, decided to split into different classes two sisters who were too passive during the courses and encouraged the other girls in the classes to support the sisters. The girls cried and suffered a lot from the separation for a few days but then became the most talented students in the school after a few months.

A change in the mindset of teachers on girls’ education.
Nai Qala’s teacher-trainers themselves come from remote rural regions of central Afghanistan, originating from poor and traditional communities. “When I was in school, I studied in a mixed class, with girls. I always had one point in my mind: why should girls come to school? They are not made for school, what for?” remembered Jawad, a 26 year old, Nai Qala teacher-trainer. The job description of the teacher-trainers puts a special emphasis on girls’ education. Teachers have not only received training on human and women’s right but have also been coached by Nai Qala staff on how to encourage girls and their parents. Jawad recounted how once he saw a girl answering a very complex math problem in front of the class, his perception about girls was changed forever: “She started to write and competently solved the problem. In that minute, I went deep in thought and questioned myself: why was I so negative about girls? Is it the society that influenced me? Many questions came to my mind and on that night I could not sleep well… After that day, I became so determined that I must help girls. This is now my third year that I teach girls and help them in scientific subjects, together with my colleagues. Up to now, I have been helping about 1000 girls between the ages of 12 to 18. I never imagined I’d be able to do my job with such motivation. It is never too late to realize that girls have the same talents and deserve the same rights as boys. I am grateful to Nai Qala for helping me to realize this important point”.

With Nai Qala’s support, hundreds of girls are on their way to university. In one of the least developed rural regions of Afghanistan, this represents an extraordinary change and brings hope. The capacity building program is a tremendous platform that allows gradual cultural changes to be brought to the remote regions and promote girls’ education.

Gender equality

Nai Qala’s actions are aimed at reducing gender inequalities   

While the world has made progress towards gender equality and women’s empowerment, women and girls continue to suffer discrimination in all regions of Afghanistan. Literacy rate of young women is still only 57 percent of that of young men [1]. The indices for education attendance ratios also show unambiguous gender disparities, which decrease with the level of education (47.6 percent of girls attend primary; 23.7 percent attend secondary and 5.2 attend tertiary education level). The share of Afghan women participating in the economy is only one third of that of men, and the indices for unemployment and the proportion of youth outside education, employment or training show a very disadvantaged position of women on the labor market.

The gender gap in both education and economy suggests that cultural impediments prohibit tapping the development potential of girls and women in Afghan society and restrict their access to education and the labor market. In order to remedy this imbalance, Nai Qala has set gender equality at the core of all its projects. Nai Qala’s vision is an educated, healthy and balanced society in which women and men lead social, cultural and economic changes in an inclusive manner that enables their children – boys and girls – to thrive, focusing on neglected parts of Afghanistan.

Ease of access to quality education and health services

Long distance to school and reluctance to send children to school are by far the most common reasons for not starting school, whereas the need for child labor and perceived irrelevance of further education were the most important reasons highlighted by ALCS for terminating education [1]. In order to reduce walking distances, Nai Qala strives to build, or refurbish, schools and improve the quality of education in remote regions. A decent and closer learning environment as well as improved education services are a big motivation for children to (re-)attend school. Katawaie is a perfect illustration of the impact of a new building on children’s registration to school. After its inauguration, the school of Katawaie became a victim of its own success as the number of girl students increased by 25 percent and new classes had to be opened in the school’s courtyard. A similar impact is been seen in Zeera Gag  where initially the school was built for 520 girls but is today attended by 650 girls.

One of the most important findings of the living condition survey (ALCS) is that the main problem of the Afghan education system is not so much retention and drop out, but first and foremost making a start at school. Nai Qala has implemented early childhood education classes in two villages and plans to open new ones. Early childhood education classes not only help boys and girls to develop their imagination, talents and confidence from a very young age, but also teach them how to play together, inclusively, as a normal habit. Newly acquired attitudes, behaviors and experiences of young children contribute to their long-term success in school and reduce drop-out rates. The early childhood program also places a special focus on mothers, by actively involving them in the class. Such a program has a particular impact on the family. Mothers build their self-confidence and most importantly their awareness of how they can educate their children at young age to contribute to a more healthy family environment.

According to ALCS, an encouraging 70 percent of all women who had a baby in Afghanistan during the last five years had at least one antenatal check-up. However, only 16 percent received four antenatal check-ups, which is the number recommended by the World Health Organization for normal pregnancies. Again, distance to a health care center can be a contributing factor to low usage of health services but it is not the only one. Men with a health concern can travel to town to get treatment in a hospital, but the situation for sick or pregnant women is more challenging. A woman who is ill must be accompanied to hospital by a female and by a male relative. Some health problems require a longer stay in hospital and some need medical follow-up over months. Furthermore, families are often reluctant to pay the costs of prolonged hospitalization. Consequently, women simply do not travel to far away hospitals. Considering this fact, Nai Qala Association built a basic health center in Nawur. The percentage of births attended by skilled health personnel there is increasing each year; for 2017 alone, 126 babies were safely delivered in the Nawur health center. This clinic benefits 20’000 people and has transformed health conditions and hygiene habits in the region, for both women and men.

Leading the change by setting an example

The Nai Qala Association aims to contribute to cultural change in Afghanistan. The organization’s president, Taiba Rahim, is a role model in a country where female leadership [2] is still rare. Inspiring girls to see that change is possible and that women have an important role to play is crucial for the country’s future. There is a greater participation of women in Nai Qala’s projects than in any other similar project in the region. The women have seen that Nai Qala’s projects are proposed and led by a woman, which makes all the difference for them. Newly acquired strength and self-confidence prompted women in the remote village of Sokhtagi to create a women’s council, the first ever women’s council not only in the district, but certainly also throughout the province.

All Nai Qala’s local employees receive training on human rights and gender equality. Each staff member embodies the organization’s values through exemplarity of his/her practice and actions, in the office and in the field. Teacher-trainers have become Nai Qala’s best ambassadors to promote girls’ education, by discussing with the community and motivating parents in door-to-door operations.

Providing women and girls with equal access to education, health services, decent work, and representation in decision-making processes can fuel sustainable economies and benefit families, and communities at large. Gender equality is not only a fundamental human right, but also a foundation for a peaceful, prosperous and sustainable country. Any small improvement towards gender equality can bring big changes in the mindset of and benefit the whole society.

 

[1] All figures are taken from the Afghanistan Living Conditions Survey 2016 – 2017 (ALCS), released May 7, 2018. Central Statistics Organization (CSO) of the Government of the Islamic Republic of Afghanistan. http://cso.gov.af/Content/files/Surveys/ALCS/Final%20English%20ALCS%20Highlight(1).pdf

[2] The percentage of women working in managerial job position is still only 6.6 percent of that of men (ALCS, 2018).

Reducing Rural Poverty – Income Generation

The income generation related to the construction site promotes the growth of a local almost non-existent economy.

Although only 12% of the country is made up of arable land, the Afghan economy relies heavily on agriculture, especially in remote areas. The primary sector supports more than 60% of the population but half of the rural households only practice subsistence farming, and therefore do not market their own production. These populations are the most affected by seasonal variations: winters are often long and harsh and to survive until spring, a large part of these small farmers must sell cattle, find a job outside agriculture or borrow money. Poverty is particularly acute in mountainous regions, where the poor road conditions and difficult access to markets add to the changeable weather conditions.

Abuzhar is 35 years old and works as a cook at the Sokhtagi school site. He is very happy to have found a job. The unexpected income prompts this father to recount: “Without this job, I could not have satisfied the needs of the five members of my family. I had no hope because I do not own land and had no prospect of income.

Mohamed, 50 years old and head of a family of eight, took the opportunity to pass his truck driving license when he learned that Nai Qala would build a school in his village. His first months salary as a driver allowed him to support his family for a year. With the salary he will receive for the second phase of the project, he plans to buy livestock. Four of Mohamed’s children attend school, three girls and one boy. Thanks to his salary and the prospect of future livestock, he is optimistic about the education of his children; he is now sure to be able to send them to school.

The arrival of a construction site in remote areas, such as the Sokhtagi school, is often a unique and unexpected opportunity to get an income. To date, 34 people work on the site of the future school, of which 26 are local employees recruited from the village specifically for the project. In addition to providing wages to workers, the construction company buys food, to feed its employees, from families or on the local market. Wages and food purchases are a welcome contribution to the growth of the local economy and reduce family poverty.

Sustainable materials

Reducing the environmental impact of construction by using local materials

It is very important to us when building community infrastructures, to reduce the environmental impact to a minimum. The energy needed for the production and transport of materials does not just increase the costs of construction considerably, but can also have a significant impact on the environment.

The  “grey energy” calculation includes the full analysis of the life cycle of the product: Planning, extraction and transport of raw materials, transformation of materials and manufacture of the product, commercialisation, transport, use and implementation and finally, any possible recycling. From this point of view, local materials that are either not transformed or only slightly transformed have a distinct advantage over the others: Stone, earth, clay, straw, wood or wool are all materials that can be used in modern construction and that have very low « grey energy ».

In the remote areas of central Afghanistan, the long distances needed for transportation increase the “grey energy” rate. The manufacture of some construction materials also plays its part in inflating the energy costs and has a negative impact on the environment. For this reason stone was chosen rather than clay bricks for the majority of Nai Qala constructions. Although there is an almost limitless availability of clay and it is totally recyclable, the firing of bricks involves high energy consumption that can last up to several days at temperatures of more than 1000 degrees. The kilns sometimes function with the use of fossil fuels or often with wood sourced from already arid regions, which contributes to deforestation.

When choosing a construction company and signing contracts the construction materials are chosen very carefully so as to ensure safety and comfort for those who use the building at the same time as keeping the environmental impact to a minimum.  For example, Sokthagi school is built from stones extracted from the nearby mountains and are cut to size on the spot. The grit and sand used for the mortar come from a river close by. Only the wood for the framework, windows and doors is transported from other regions. The sourcing of materials brings about a more positive ecological balance to the construction.

Photographic exhibition

A photographic exhibition shows a positive image of Afghanistan and the changes that are taking place there.

Since 2007 the Nai Qala Association, through education has helped to create hope and opportunities in one of the most isolated areas of Afghanistan. Despite extreme poverty and the remoteness of the communities it is not despair and distress that we found there, but dignity and determination.

In 2017, to mark its 10th anniversary, Nai Qala asked a professional photographer, Haris Coussidis, who visited Afghanistan to take photos of the association’s activities, to make a pictorial record of the projects and their impact on the communities. This photographic report is part of a campaign to show the world that Afghans are committed to education, particularly for girls.

The association’s president presented the work to the city and canton of Geneva, who decided to support the association for an exhibition, which took place at “La Rotonde du Mont Blanc” from the 5th to the 25th March 2018.

This exhibition titled, “Women’s education, a hope for Afghanistan”, took place during the Geneva Equality week and the Human Rights Council, which was aptly symbolic for our work. Through these photographs we wanted to show a different side to Afghanistan, a positive image of men, women and children just like any others in the world – an image of a people with hope, aspiration and in search of opportunities. We wished to share the bravery of the parents in these rural regions, who despite poverty encouraged their girls to go to school to prepare a better future.

With particularly changeable weather, Nai Qala showcased on the Geneva lakeside. The exhibition was inaugurated with a press conference and opened with a debate which was covered by Swiss and international media.

Click here for a snapshot of the pictures that were shown in Geneva, including their captions.

Access the exhibition slide show here.

A clinic focusing on women

In the Nawur clinic project, mothers and babies are the primary focus of Nai Qala.

Men with a health concern can travel to town to get treatment in a hospital, but the situation for women is more challenging. A woman who is ill must be accompanied to hospital by at least one other female family member and by a male family member. If the woman has children, she must leave them behind if she goes for treatment. Some health problems require a longer stay in hospital and some need medical follow-up over months. Furthermore, families are often reluctant to pay the costs of prolonged hospitalization. Consequently, women simply do not travel to clinics or hospitals that are far away. This is one reason for high female and child mortality rates and it is also why the Nai Qala Association built the Nawur clinic.

Inaugurated in November 2011, the clinic now has 11 staff providing health services for a population of 20,000 in the surrounding region. Since its opening, there have been more than 60,000 consultations, of which over 11,000 concerned children. Some 750 babies had been born in the clinic as of December 2017.

Nai Qala Association is proud to have been in direct contact with the Ministry of Public Health since the beginning of the project. Our original partnership with the ministry was from 2012 to 2016 and we were offered an extension to 2020. The administration of the Nawur clinic was transferred to the ministry in June 2015. In many official meetings the example of the Nawur health centre has been cited to show that it is possible to provide health services to one of the most isolated regions of Afghanistan.

Women in Nawur typically have large families. It is unusual to see a couple with fewer than five children. Most families have more, and it is not outside the norm to have 12 children. Observers may question why parents have such large families, especially given the economic limitations. However, where the survival rate of children is low, it is understandable that parents have more to increase the chance that some will survive. Limitations in care both during pregnancy and in the postpartum period leave mothers and babies at risk.

Reducing or eliminating these risks will reduce parents’ anxiety about their children’s survival and will foster a subsequent reduction in supernumerary pregnancies. The clinic is vital to reducing these pervasive risks.

As of the end of December 2017, 3156 women and 1022 children had been vaccinated in the clinic. Some 13,000 outpatient visits took place for a range of conditions that, without the clinic, would have gone untreated until they became far more serious, and the records show 125 cases of severe malnutrition receiving medical care. Some 175 Nawur patients were referred to other health facilities for more specialized treatment.

The local people have realized the clinic’s value – more women and babies are surviving – and they are determined not to give it up.