We commonly use the visual analogue scale in the ED to measure pain. The visual analogue scale is a “measurement instrument that tries tomeasure a characteristic or attitude that is believed to range across a continuum of values and cannot easily be directly measured.”
This turned out to be a great measurement tool for the drought early warning system. Not only in its ability to measure perceptions in such a unique culture and context, but also it’s a tool that exists in a simple format, where a fingertip or penmark can translate into a number.
In this part of the world, village women are very keen on when their children become under/malnourished. Traditional measurements of child malnutrition like MUACs are commonly used but I’m pretty confident that pastoralists women don’t regularly walk around measuring their children’s arms with tape. But they believe they know when their children become malnourished before any NGO comes to measure their child’s upper arm. So why not complement intermittent nutrition assessments with monthly perception based VAS scales? And engage and empower women with their communities to share their views in this way?
With 25 indicators we built an information, communication and feedback system. And to implement this drought early warning system there were many training sessions. Here is a snapshot of our training in 2008.
I mentioned in an earlier post I have been asked to return to Ethiopia to help assess feasible approaches to integrating (I)nformation (C)ommunication (T)echnoloy (ICT) into a drought early warning program.
While for many projects the “T” often supersedes the I & C, I’d like to think that this project has evolved in a bit of a different way.
Back in 2006 during my emergency medicine residency training at HAEMR I had the opportunity to support an international NGO with a regional office in Addis Ababa. A severe drought had just affected the southern pastoralist communities decimating almost all of their cows, goats an sheep- their primary livelihood. So how does this affect the health of communities? And for those of us who think primarily in terms of human health, how does this connect?
It’s an intertwined ecosystem. Access to water, adequate rainfall, and good pasture, are tightly linked to an animal’s ability to produce milk for human consumption. When there is impending drought the people sell their primary source of nutrition- their livestock back into the markets to purchase grain for food. This spins a dangerous web for not only the health of already undernourished children but also for pregnant women, the elderly and entire communities.
For this project, a public health lens for drought early warning is centered on community perspectives. And village women’s ability to report early changes becomes one of the cornerstones of early warning. Women, clan leaders and local colleagues taught me years ago- it’s just as much about the pasture as it is about the number of visits to the health center. In 2006-7 the project aimed to complement existing early warning systems which often struggle to collect timely and actionable information to prevent the deleterious outcome of droughts/famine.
The conversations began years ago with women in Tuka, Arganne, and Danmbi. (focus groups) where they described community perspectives on early signs of drought, their coping mechanisms and ongoing community needs. And we worked with their knowledge and perceptions to build indicators using survey measurement tools we commonly use in the ED and in social science research— the Visual Analogue Scale
This is the list that I use almost everytime I travel to the field. It includes everything from toiletries to passport/visa info to eletronics.
Here’s a photo of what’s in the backpack, cliff bars, shampoo, 3 usb data sticks to hopefully connect to the Ethiopian cell phone towers, a surge protector, and car charger. Somewhere in there is my clothes, my deet and water bottle.
I’ve spent the past few days, getting ramped up to return to southern Ethiopia. This time I’m heading back to Moyale, Ethiopia at the border of Ethiopia and Kenya to put together a strategy for integrating low technology options for a community based drought early warning system. Back in 2006, I helped conceptualize collecting public health and livelihoods information for decision making of communities, local government offices and an international NGO. 6 years later I’m heading back again but this time in another role, but with a very similar perspective. More on that in another blog!
But so much of what we do in the humanitarian sector is about providing support to affected communities during disasters & conflict. Gearing up to do that in the field, requires a lot of logistics and planning.
Here is a photo of my field backpack. 11kg, in weight. ( better then my 13kg for Mozambique!) and less than what is required on a UN Charter flight. In 2006, water was somewhat reliable, electricity every other day, and Plasmodium falciparum is prevalent.- so this affects what you pack and how you prepare.
As tech always goes, I’m sitting in the Frankfurt airport trying to upload a photo for this blog but failed 3 times. Good times, and I’m in a fully developed country 😉
So what’s in that backpack?
Will be in touch when I arrive in Addis Ababa.