The Humanitarian Times

April 10, 2000


-MADAGASCAR & OTH SUB-SAHARAN AFRICAN COUNTRIES REQUIRE FOOD AID reports FAO in its April "Food Supply Situation" update, saying "In Madagascar, heavy rains & high winds... (led to) damage to coffee plantations, fruit trees & paddy crop in low-lying areas." Large food deficits exist in Ethiopia, Kenya, Somalia & Burundi.

-ETHIOPIAN FOOD CRISIS DEMONSTRATES WEAKNESSES IN REPORTING. While relief groups increasingly broadcast warnings of famine in Ethiopia, few are able to provide trend data & refer, instead, to general govt appeals for food aid, & observe that some children are dying (a statistic found in any large population). Medicines Sans Frontieres says it's wary of data coming from the region, (AFP).

One nutrition survey of the famine-affected area showed comparable levels of mild & of severe malnutrition, which is not statistically likely in a representative survey; suggesting that the survey over- selected for children who are very malnourished, as often happens when surveys are done at a relief feeding site. Several news reports allude to epidemics but provide no information about communicable diseases. Oxfam UK is urging donors to bring food aid in excess of immediate needs, thus to preventively pre-position food stocks in- theater before summer rains impair inland road transport.

-RAPID EMPLOYMENT PROGRAMS PROMOTED IN EAST TIMOR FOR RECONSTRUCTION & to prevent future conflict, in programs initiated by UNTAET, UNDP, the World Bank, ILO & USAID's Off. Transition Initiatives

-CIVILIAN EXECUTIONS, TORTURE, & EXTRAJUDICIAL DETENTION BY RUSSIANS are reported by Physicians for Human Rights, from interviews with 326 Chechens randomly selected from refugees in Ingushetia. 44% of those surveyed witnessed Russians killing one or more Chechen civilians; see:

-RUSSIA'S KREMLIN SAYS NEWS REPORTs ON CHECHNYA ARE TERRORIST & ILLEGAL if it quotes Chechen leaders, whether in hard print & internet news publications, in a decree issued last month. Chechen leader, Field Commander, Shamil Basayev responds: "Putin deliberately distorts the facts...imposing a news blackout about the fighting in Chechnya. If he had really achieved victories in Chechnya, he would have allowed independent journalists," &, writing on the web, says that the successful evacuation of rebel forces from Grozny "is a slap in the face for the Russian Military Command that claimed that it would not allow any of the Mujahideen to exit the city." A Chechen website ( says its army is now focusing on mobile attacks against Russians who in turn avoid frontal assaults, but shell from a distance: "Russians are carrying out mass-repressions against the civilian population of the town of Vedeno." Last week, newly elected Russian Pres. Putin denied UN Human Rights Comm. access to detention camps in Chechnya, but agreed to allow visits by the Intl. Comm. of the Red Cross (ICRC).

-TROPICAL LOWLANDS IN SE BOLIVIA FLOODED, LANDSLIDES FROM HEAVY RAINS; while the govt declared a state of emergency to allow it to crack down on street protesters in highland Cochabamba.

- UN SEC. GEN. K ANNAN PROMOTES ELECTRONIC INFO. EXCHANGE FOR POOR countries, including a "Health Inter-Network" on medical advances & a UN Technology Service to give technical training on Internet use, though, observing, "globalization...can dislocation at lightning speed." Annan also suggests better sanctions targeting & transparency of arms flows to conflicts, in his "Millennium" report last week to the UN Gen. Assembly, titled "We the Peoples of the UN in the 21st Century"; see:

- CANADIAN LANDMINE FUND SOLICITS CREATIVE ANTI-LANDMINE PROJECT ideas, primarily from Canadian groups, for funding via the Canadian Intl. Development Agency. Contact:



CORRECTIONS: - Some copies of the Feb. 29 inaccurately said that adult US males are 1 meter taller today than their ancestors a few centuries ago. The true figure is closer to 10 centimeters.

- The April 5 edition should have said that the Intl. Committee of the Red Cross (ICRC) won, or shared in winning the Nobel Peace Prize in years 1901, 1917, 1944, 1963 & (as part of the campaign to ban landmines) in 1997 (not 1998, as written).

AMERICAN RED CROSS REPLIES TO FEB. 5 ARTICLE: Al Panico, American Red Cross VP for Intl. Services, wrote to The Humanitarian Times saying that The Humanitarian Times' reportage (about the American Red Cross' approach to promote recognition of the Israeli relief society, MDA, as being a political use of humanitarian aid) was "outrageous" & flawed. He writes, "the American Red Cross's intl contributions & involvement have been growing by leaps and bounds.

We will never allow policy differences with Geneva - large or small - to interfere with our mission to prevent & alleviate human suffering.

Over the past 8 months, the American Red Cross has responded to emergencies in Turkey, Taiwan, Venezuela & Mozambique while continuing involvement in...Russia, the Balkans & C. America." With regard to relations with the Federation: "Withholding membership dues to Geneva is a matter of principle, not politics." Panico writes that the American Red Cross approach has been consistent in urging the "use of inter-temporal doctrine (grandfathering) to immediately recognize the MDA" for at least 2 years; & more general support on the MDA society was put forth in a 1989 resolution. Panico says that current recognition of the red crescent emblem, used by many national societies, shows that ICRC has already applied grand-fathering for some countries, but not for Israel. He asks, "Why not for the Magen David Adom, a humanitarian society which has used its emblem for the last 70 years?"




David Werner, after seeing the lack of health care available in rural mt. towns of NW Mexico in the early 1970s, prepared & published a health-care manual, "Donde No Hay Doctor" (English: Where There is No Doctor), written to be readable by laypersons. It has become the most used health text in the world, translated into 86+ languages, & used by intl. NGOs in refugee relief as it outlines primary care in situations of scarce resources. Werner's writings help poor people solve their own health problems, blending diagnosis & disease control with behavior change & prevention. Written without jargon & with simple yet excellent illustrations, Werner's books have established a style that inspired similar texts (including "where there is no car mechanic"). Many of them were developed & published by the Berkeley, CA-based Hesperian Foundation (which had originally been set up to channel aid to the 1968 crisis in Biafra Nigeria). Today the Hesperian Fdtn. (website: publishes a range of titles intended to de-mystify medical knowledge.

The Hesperian Fdtn is currently preparing new publications on community mental health, early interventions for small children with impairments, women with disabilities, environmental health & a safety guide for workers in export-processing industries. The Hesperian Fndn has an open copyright policy that encourages adaptations without royalties (for not-for-profit applications).

- "WHERE THERE IS NO DOCTOR: A VILLAGE HEALTH CARE HANDBOOK" by David Werner (1992 Berkeley, CA: Hesperian Fdtn ISBN 0-94-2364-15-5) steps the reader through a range of diseases, physical conditions & dysfunctional social behaviors. Werner educations about the biological cycle of key diseases, balancing discussion of symptoms, therapy, control & prevention, including behavior modification. The book does not encourage laypersons to attempt surgery, but it does explain more basic emergency-room practices: how to close large cuts, set a splint for broken bones. Werner includes a draws on modern public health findings, such as the protective benefits of foods rich in vitamins & minerals, including dark green & yellow vegetables. Werner sprinkles key maxims, such as: "Always use iodized salt" & moves easily between anatomy & politics, for example, advocating: "improved use of land through rotating crops, contour ditches, irrigation, breeding fish, bee- keeping, grain storage & planting family gardens." "Any child with watery diarrhea is in danger of not wait for dehydration to begin...For most cases of diarrhea no medicine is needed." The text is oriented toward grassroots, community-organized solutions. But it links poorly to more in-depth, technical & nuanced disease care protocols that, for example, the World Health Organ. (& other donors such as USAID) update continuously.

- "HELPING HEALTH WORKERS LEARN: A BOOK OF METHODS, AIDS & IDEAS" by D Werner & B Bower (1982 Hesperian ISBN 0-942364-10-4) is one of the few comprehensive how-to books on teaching health principles in communities. It was prepared as a companion volume to "Where There is No Doctor," & some sections serve as a teaching guide for its use.

Most of the text presents activities -- such as role playing, theater -- & how group efforts can help communities identify which health behaviors are helpful & which are harmful. Throughout, the text lends comfort to creative use of homemade low-cost equipment. Key health messages are proposed, including the importance of keeping vaccines cold & the logic for how spacing out births is likely to reduce risk of malnutrition among young children.

- "WHERE WOMEN HAVE NO DOCTOR: A HEALTH GUIDE FOR WOMEN" by AA Burns, R Lovich, J Maxwell & K Shapiro (1997 Hesperian) will soon be available in 31 languages, & also complements "Where There is No Doctor" by giving more depth on a range of reproductive health skills, including prevention of HIV/AIDS.

- "DISABLED VILLAGE CHILDREN: A GUIDE FOR REHABILITATION WORKERS" (David Werner 1987 Hesperian ISBN 0-942364-06-6) explains with photos rural village-based physical rehabilitation activities, including prosthetics, to help with physical disabilities, including many common in post-conflict settings, i.e. from landmines.

- "WHERE THERE IS NO DENTIST" (1983) BY MURRAY DICKSON (Hesperian Fndn ISBN 0-942364-05-8) avoids technical jargon but assumes & explains the use of basic specialized instruments (probe, elevator, forceps), & local anesthetics (lidocaine). Dickson cautions "Know your limits; do only what you know how to do."

- "WHERE THERE IS NO VET" FOR ANIMAL CARE BY BILL FORSE (1999 London: Macmillan ISBN 0-85598-409-0) is not a Hesperian Fdtn publication, though Hesperian advised early on. It follows the style of presentation of the books reviewed above, explaining symptoms, causes, prevention & control. It recognizes different cultural approaches to animal use, for example how different cultures wean young animals off maternal milk. It deals mostly with sheep, pigs, cows, horses, donkeys, & chickens. Many maxims, i.e."It is dangerous to open the body of an animal with Rift Valley fever because people can get this disease. Dispose of the body carefully like the body of an animal with anthrax." Much of vet care involves interpretation of lumps, swelling, eating/digestion, & birthing difficulties -- "Do not pull on the legs of a baby animal as soon as they appear. It will not help and you might harm the mother." Appropriately, advice includes prevention measures, such as keeping animals from wet places where snails carry liver flukes. A similar text, "Where There is No Animal Doctor", was also published last year, written by P Quesenberry & M Birmingham, & available from Christian Veterinary Mission (World Concern):

David Werner left the Hesperian Fdtn several years ago & today works for HealthWrights in Calif., publishing: "Questioning the Solution: The Politics of Primary Health Care & Child Survival, With an In-Depth Critique of Oral Rehydration Therapy" as well as "Nothing About Us Without Us: Developing Innovative Technologies For, By & With Disabled Persons." Werner is now assisting the Intl People's Health Council to encourage WHO & UNICEF to strengthen health rights of the poor:


April 10, 2000 The Humanitarian Times

Subscriptions to The Humanitarian Times are free.

To subscribe or unsubscribe, email: