Overwhelmed Healthcare Systems in Gaza Struggle Through Evacuation Orders

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Humanitarian Emergencies

Displaced families in Gaza are on the move after the latest Israeli evacuation orders. Around nine in 10 Gazans have been displaced at least once since the war began. Photo: UNRWA

Displaced families in Gaza are on the move after the latest Israeli evacuation orders. Around nine in 10 Gazans have been displaced at least once since the war began. Photo: UNRWA

UNITED NATIONS, Jul 12 2024 (IPS) – For nine months, over 2 million people in the Gaza Strip have been forcibly displaced in the wake of the armed conflict between Israel and Hamas. The ongoing fighting and displacement have put significant strain on humanitarian organizations on the ground to address even basic health needs.

The United Nations and other humanitarian organizations have stressed that the healthcare system in Gaza has collapsed or has suffered undue pressure as a result of the fighting. Out of 36 hospitals in the area, 13 remain open, operating with partial functionality.

This includes Nasser Hospital, which now stands as the last hospital providing comprehensive healthcare services. It has been overwhelmed with patients in the wake of evacuation orders issued on July 1 by Israeli authorities for the east and south of Khan Younis. Patients and medical personnel working in the Gaza European Hospital, located in Khan Younis, evacuated ahead of time.

Although an official from the Israeli defense force stated that patients and medical personnel were exempt from the evacuation order, this was not conveyed to the humanitarian groups on the ground. 

Andrea de Domenico, UN-OCHA’s Head of Office in the Occupied Palestinian Territory, told reporters in a virtual press briefing on July 3 that OCHA was not informed. He stated that it was likely that those who evacuated acted based on past experiences where hospitals were specifically targeted for raids or military bombardment, and so they took preemptive measures to evacuate before the Israeli military moved in on Khan Younis.

Evacuation orders have devastating implications for the fragile health infrastructure by disrupting the functionality of health facilities within and adjacent to evacuation zones, as one spokesperson from the World Health Organization (WHO) told IPS. They impede access for both healthcare providers and patients, and they compromise the efficacy and security of humanitarian operations. In addition, this only increases the burden on other hospitals that are now charged with receiving patients from evacuated areas.

As one of the remaining hospitals providing comprehensive care, Nasser Hospital has been operating beyond capacity with limited supplies, amidst destruction in the surrounding area, which WHO staff on the ground have said is ‘indescribable’. The area surrounding the hospital is laden with heavy layers of debris, destroyed buildings, and no stretch of an intact road. Its pediatric ward has now hosted more than 120 patients since July 5, despite its 56-bed capacity.

OCHA and the World Health at Nasser Medical Complex in Gaza earlier this year. UN and other humanitarian agencies have been struggling to ensure health care continues. Credit: OCHA

OCHA and the World Health at Nasser Medical Complex in Gaza earlier this year. UN and other humanitarian agencies have been struggling to ensure health care continues. Credit: OCHA

It is also operating with dwindling medical supplies and holds responsibility for sterilizing equipment for the surrounding field hospitals, according to Doctors Without Borders (DWB). Despite the critical need for supplies, DWB trucks and convoys carrying these supplies have been unable to enter Gaza since April. As recently as July 3, trucks were denied entry due to ongoing fighting in the South.

“Overall, it’s a comprehensive issue—from shortages of beds and supplies to the lack of surgeons. With yet another hospital closed, patients’ lives are even more at risk,” said medical team leader Javid Abdelmoneim, working in Nasser Hospital.

The issue of life-saving aid being restricted from entering Gaza has continued to persist and impact operations for humanitarian organizations on the ground, including the UN. As the WHO spokesperson told IPS, their trucks were unable to pass through last week as the Karem Shalom crossing remains closed.

Fuel has been identified as critical to the functionality of health facilities and aid operations, and yet shortages are rampant. A WHO spokesperson stated that hospitals have been forced to work with limited supplies of fuel, electricity and solar systems, and this has only hindered groups from properly functioning.

Power blackouts in newborn/ICU and kidney dialysis units place their patients at critical risk. The lack of fuel also impacts the water and sanitation sectors, which require at least seventy-thousand liters of fuel a day, and yet in the last few weeks, they have only received less than ten percent of what is needed.

Only 500,000 liters of fuel have been brought in during the first week of July, and 2 million liters were brought in in the month of June, which humanitarian organizations note is a fraction of the fuel needed to sustain humanitarian, medical, and WASH operations—at least 400,000 liters per day.

Trash and sewage buildup and a lack of clean water, among other factors, have all led to the spread of water-borne diseases and upper respiratory infections. According to the WHO, since mid-October 2023, they have reported cases of diarrhea, lice and scabies, skin rashes, impetigo and chicken pox.

“While a healthy body can more easily fight off diseases, a wasted and weakened body will struggle and become more susceptible,” one WHO spokesperson told IPS.

Meanwhile, acute food insecurity has ravaged Gaza. Since the start of the war, food insecurity has been a major concern for humanitarian actors in the region and globally.

The Integrated Phase Classification (IPC)’s special brief acute food insecurity projected that 96 percent of Gaza’s population, or 2.15 million people, would be experiencing extreme levels of food insecurity between June 16 and September 30, which includes over 495,000 people who face catastrophic food insecurity. More than half of the households reported that often, they did not have any food in the household, and more than 20 percent go full days and nights without eating. The violence and repeated displacement have challenged people’s ability to cope or to access humanitarian assistance.

This is further exacerbated when humanitarian workers are also forced to relocate for their own safety and move their operations. Domenico stated that the constant movement also means that warehouses containing fuel and supplies are abandoned as a result. In the case of UN agencies such as OCHA and its partners, humanitarian operations may be considered a parameter of activity that is (or should be) protected from military activity. Their presence is likely to signal to people that it may be safe to be there or that their basic needs will be met.

So far, 34 people have died from malnutrition and dehydration, according to the Ministry of Health. Of those deaths, WHO notes that 28 of them are children. A group of independent experts has warned that famine has spread throughout the Gaza Strip, noting recent cases of children who have died due to hunger and malnutrition, one of whom was as young as six months old.

“With the death of these children from starvation despite medical treatment in central Gaza, there is no doubt that famine has spread from northern Gaza into central and southern Gaza,” the experts said in a shared statement.

The IPC special brief notes that only a cessation of the armed conflict and sustained, uninterrupted humanitarian intervention could reduce the risk of famine. Humanitarian organizations have struggled to maintain their operations while hostilities have persisted in the Gaza Strip, endangering and displacing more than a million civilians multiple times over, along with humanitarian workers who have risked their lives to continue providing what little life-saving aid can cross the border. Military violence has continued despite international condemnation and repeated demands for a ceasefire.

Organizations such as WHO and Doctors Without Borders have coordinated with health partners and agencies on the ground, namely UNRWA, to provide primary care, support vaccination campaigns, and deploy emergency medical teams. As the WHO notes, however, these efforts can only support the health system; they cannot replace it.

IPS UN Bureau Report

Note: This feature was published with the support of the Riana Group.


Conditions Worsen for Belarus Migrants Stuck in ‘Death Zone’ on EU Border

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Migration & Refugees

Aid agencies say that refugees caught on the Polish and Belarus borders are subject to brutal pushbacks. Graphic: IPS

Aid agencies say that refugees caught on the Polish and Belarus borders are subject to brutal pushbacks. Graphic: IPS

BRATISLAVA, Apr 25 2024 (IPS) – As the refugee crisis on the Belarus/EU borders approaches its fourth year, a crackdown on activism in Belarus is worsening the situation for migrants stuck in a “death zone” as they attempt to leave the country.

Groups working with refugees say the repression of NGOs in Belarus has led to many organizations stopping their aid work for migrants, leaving them with limited or no humanitarian help.

And although international organizations are operating in the country providing some services to refugees, NGOs fear it is not enough.

“There have been elevated levels of violence [against refugees from border guards] since the start of this crisis. But what has got worse is that before there were more people willing to help these refugees in Belarus, but now there is pretty much no one there helping as activism can be punished criminally in the country,” Enira Bronitskaya, human rights activist at Belarussian NGO Human Constanta, which was forced to pull out of the country and now operates from Poland, told IPS.

Since the start of the refugee crisis on the Belarus/EU border in the summer of 2021, rights groups have spoken out over brutal refugee ‘pushbacks’ by guards on both sides of the border.

Some have accused Minsk of manufacturing the crisis as a response to EU sanctions. They say Belarusian authorities actively organize, encourage, and even force migrants to attempt crossings over the border, but at the same time sanction violent and degrading treatment of those same migrants by border guards.

But others have also raised issue with what they say are equally violent and inhumane methods used by EU border guards in Poland, Latvia and Lithuania against those same migrants, as well as systematic breaches of their rights to claim asylum.

“These people are subjected to numerous forms of violence, both by Belarusian and Polish border guards. We’ve seen bruises, black eyes, knocked-out teeth after blows, kicks or hits with the back of rifles, irritation of skin and eyes after being sprayed with pepper gas, and teeth marks after dog bites,” Bartek Rumienczyk of the Polish NGO We Are Monitoring (WAM), which helps migrants who arrive in Poland from Belarus, told IPS.

“We also tell people they are entitled to ask for international protection in Poland, but in practice, these pleas are often ignored by border guards. We have witnessed numerous situations when people were asking for asylum in our presence and still they were pushed back to Belarus,” he added

These practices leave people stranded between the two borders in terrible conditions. Some aid workers describe it as a “death zone”.

“Refugees who manage to make it over [into the EU] talk about the ‘death zone’ between fences on the EU border and razor wires on the Belarus side and border guards who will not let them back into Belarus. They are therefore stuck there,” Joanna Ladomirska, Medical Coordinator for Medecins sans Frontieres (MSF) in Poland, told IPS.

“This death zone runs all along the Belarus/EU border, and it is huge—maybe tens of thousands of square kilometers—and no one knows how many people might have died there, or might be there needing treatment. My worry is that no one has access to this zone—not NGOs, no one,” she added.

At least 94 people have been known to have died in the border area since the start of the crisis, according to Human Constanta’s research, although it is thought many more may have also lost their lives.

Those that do manage to cross the border are invariably injured, some seriously. Exhaustion, hypothermia, and gastrointestinal affections because migrants have been forced to drink water from swamps or rivers are common, while almost a third of them have trench foot, and many have suffered serious injuries from razor- and barbed-wire fences. Some have also had to have parts of their limbs amputated due to frostbite, according to aid groups providing medical care to them.

Although both international and local organizations continue to work to help migrants on the EU side of the border, this is much more limited on the Belarusian side, say those working directly with migrants.

Since mass protests following his re-election in 2020, autocratic Belarusian President Alexander Lukashenko has implemented a sweeping crackdown on dissent. This has seen, among others, widespread prosecutions of workers in civil society.

Many NGOs, including some that had previously helped migrants, have been forced to close, leaving only a handful of major international organizations to do what they can for migrants.

However, questions have been raised about how effective their operations are.

“There are international organizations like the ICRC that are working with the Red Cross, but the Belarus Red Cross is only handing out food parcels in certain areas; it’s not a regular, stable supply,” said Bronitskaya.

“Basically, there is no one there giving [the migrants] the help they need. It is very possible there will be even more deaths than before,” she added.

But it is not just those stuck between the borders who are struggling to get help.

Anyone who fails to get into the EU and finds themselves back in Belarus is classed as an irregular migrant, is unable to access healthcare or benefits, and cannot legally work.

Many quickly find themselves in poverty, living in constant fear of being discovered by immigration authorities, and vulnerable to exploitation. Some aid workers told IPS they had heard of migrants in Minsk and other Belarussian cities forced to turn to prostitution to pay to support themselves.

Facing such problems, many decide they have little choice but to attempt the crossing again despite the risks.

Aid organizations and global rights groups say governments in EU countries and in Minsk must adhere to their obligations to protect the rights of these migrants.

“It’s not the best approach to the situation if the EU makes it difficult or impossible to cross its border by building walls or putting up legal barriers, nor is it good if Belarus creates a situation where people are stranded,” Normal Sitali, Medical Operations Manager for Medecins sans Frontieres (MSF) in Belarus, told IPS.

“There must be unhindered access to the border area for independent humanitarian organizations and for international and civil society organizations to respond to the dire situation there. Governments need to look at ensuring access to healthcare for these people so that international organizations do not need to provide and pay for it; they also need to look at legal protections for them; and they need to examine how these people can be ensured the space and protection to claim their rights as individuals while in transit,” he added.

MSF, which helped thousands of migrants during the crisis, last year stopped providing services to them after deciding migrants’ medical needs were outweighed by their need for protection and legal support, which MSF says can only be provided by dedicated organisations with specific expertise.

But some doubt the situation will improve any time soon with political relations between Belarus and the EU badly strained.

“Governments need to do something but the political situation makes things complicated. EU governments will not negotiate with Lukashenko because of the repressions going on in Belarus. Unless there is some significant change, nothing is going to get better,” said Bronitskaya.

However, others are hopeful of change.

Officials in Poland’s new government, which came to power in December last year, have claimed the number of pushbacks has fallen under the new administration and said a new border and migration policy is being drawn up that would treat the protection of human rights as a priority. Plans are also being put in place for the border forces to set up special search and rescue groups to stop humanitarian crises at the country’s borders, they have said.

“As a European country, [Poland] should respect European human rights laws and provide people with access to safety. You don’t need to negotiate with the Belarus regime to do that,” Ladomirska told IPS.

“I hope that with the new Polish government, something might change. We’re talking to them; change is feasible, and with the new government, there is an opportunity for that change.”

IPS UN Bureau Report


Abandoned Children Growing Problem in Northern Syria

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Humanitarian Emergencies

Children eating and drinking at the Children's House in Idlib. Abandoned children is a growing issue in the region. Credit: Sonia Al-Ali/IPS

Children eating and drinking at the Children’s House in Idlib. Abandoned children is a growing issue in the region. Credit: Sonia Al-Ali/IPS

IDLIB, Syria, Mar 27 2024 (IPS) – Wael Al-Hassan was returning from work in the Syrian city of Harim when he heard the sound of a baby crying.

He was returning from work on December 10, 2023. He stopped momentarily, turned on his mobile phone flashlight to investigate, and spotted a baby girl, around one month old, wrapped in a white blanket, lying by the roadside.

He felt saddened by the infant’s condition and said, “She was crying loudly, and I saw scratches on her face from cat or dog claws. I then carried her in my arms and took her home, where my wife breastfed her, changed her clothes, and took care of her.”

The phenomenon of abandoning newborns is increasing in northern Syria, where individuals leave their newborns in public parks or alongside roads, then leave the area. Passersby later find the infants, some of them dead from hunger or cold.

Al-Hassan said that the next morning, he handed the baby girl over to the police to search for her family and relatives.

Social Rejection

Social worker Abeer Al-Hamoud from the city of Idlib, located in northern Syria, attributes the primary reason for some families abandoning their children to the widespread poverty and high population density in the province. Additionally, there is fear of the security situation (the area is not in the control of the Syrian regime and is often under attack), the prevalence of divorces, and spouses abandoning their families after traveling abroad.

Al-Hamoud also points out another reason, which is the spread of the phenomenon of early marriage and marrying girls to foreign fighters who came from their countries to Syria to participate in combat. Under pressure from their families, wives often have to abandon their children after their husband’s death, sudden disappearance, or return to their homeland, especially when they are unable to care for them or provide for them financially. Moreover, these children have no proper documentation of parentage.

Furthermore, Al-Hamoud mentions another reason, which is some women are raped, leading them to abandon their newborns out of fear of punishment from their families or societal stigma.

Al-Hamoud warns that the number of abandoned children is increasing and says there is an urgent need to find solutions to protect them from exploitation, oppression, and societal discrimination they may face. She emphasizes that the solutions lie in returning displaced persons to their homes, improving living conditions for families, raising awareness among families about the importance of family planning, and launching campaigns to integrate these children into society.

Alternative Families

It’s preferable for members of the community to accept these children into their families, but they face difficulties in registering the births.

Thirty-nine-year-old Samaheer Al-Khalaf from the city of Sarmada in northern Idlib province, Syria, sponsored a newborn found abandoned at a park gate, and she welcomed him into her family.

She says, “After 11 years of marriage to my cousin, we were not blessed with children, so we decided to raise a child found in the city at the beginning of 2022.”

Al-Khalaf observes that the Islamic religion’s prohibition on “adoption” prevents her from registering the child under her name in the civil registry. Additionally, she cannot go to areas controlled by the Syrian regime to register him due to the presence of security barriers.

She says, “I fear for this child’s future because he will remain of unknown lineage. He will live deprived of his civil rights, such as education and healthcare, and he won’t be able to obtain official documents.”

Children’s House Provides Assistance

With the increasing numbers of children of unknown parentage, volunteers have opened a center to receive and care for the children abandoned by their families.

Younes Abu Amin, the director of Children’s House, says, “A child of unknown parentage is one who was found and whose father is unknown, or children whose parentage has not been proven and who have no provider.”

“The organization ‘Children’s House’ opened a center to care for children separated from their families and children of unknown parentage in the city of Sarmada, north of Idlib,” says Abu Amin. “The number of registered children in the center has reached 267, ranging in age from one day to 18 years. Some have been placed with foster families, while others currently reside in the center, receiving all their needs, including shelter, food, education, and healthcare.”

Upon arrival at the center, Abu Amin notes that the center registers each child in its records, transfers them to the shelter department, and makes efforts to locate their original family or relatives and send them to them or to find a foster family to provide them with a decent life.

Abu Amin explains that the center employs 20 staff members who provide children with care, psychological support, and education. They work to create a suitable environment for the children and support them psychologically to help with emotional support.

He emphasizes that the center survives on individual donations to cover its expenses – which are scarce. There is an urgent need for sufficient support, as the children require long-term care, especially newborns.

A young girl Marah (8) and her brother, Kamal (10), lost their father in the war. Their mother remarried, leaving them to live in a small tent with their grandfather, who forces them to beg and sell tissues, often leaving them without food for days.

Consequently, they decided to escape from home. Kamal says, “We used to sleep outdoors, overwhelmed by fear, cold, and hunger, until someone took us to the child center.”

Upon reaching the center, they returned to their studies, played with other children, and each other, just like children with families.

Kamal expresses his wish, “I hope to continue my education with my sister so we can rely on ourselves and escape from a life of injustice and deprivation.”

These children, innocent of any wrongdoing, are often left to fend for themselves, bearing the brunt of war-induced poverty, insecurity, homelessness, instability, and early marriage.

IPS UN Bureau Report


UNWRA Chief Warns Agency’s Fate ‘Hangs in the Balance’

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Philippe Lazzarini, Commissioner-General of the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), briefs reporters at UN Headquarters.

Philippe Lazzarini, Commissioner-General of the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), briefs reporters at UN Headquarters.

UNITED NATIONS, Mar 6 2024 (IPS) – UNRWA Commissioner-General Philippe Lazzarini asked the UN General Assembly to urge member states to support the organization’s mandate during this period of unprecedented crisis for the region and the agency. He also called for member states to facilitate a “long-overdue political process” for the two-state solution for Israel and Palestine. Only then, in this context, should UNRWA be allowed to transition.

He was speaking at an informal session of the General Assembly on the United Nations Relief and Works Agency for Palestinian Refugees in the Near East (UNRWA). This was convened to discuss the ongoing situation with UNRWA’s capacity as a humanitarian and human development agency in Gaza.

Despite its existence for 75 years, UNRWA’s presence was always intended to be temporary. “It is a stain on our collective conscience that for 75 years, UNRWA has had to fill a vacuum left by the lack of a political solution and genuine peace,” said Lazzarini.

The ongoing hostilities in the Gaza Strip and the resulting destruction of UNRWA facilities, which have disrupted humanitarian services in the region, have led to calls to seek alternatives that can deliver on the scale of the agency or to raise concern about whether other agencies can deliver the necessary humanitarian aid.

“UNRWA is facing a deliberate and concerted campaign to undermine its operations and ultimately end them,” said Lazzarini.

Lazzarini argued that dismantling UNRWA during the current crisis would be shortsighted, given that the agency was designed to provide public services such as education and primary healthcare in a region without state authority. “The notion that the Agency can be dismantled without violating a host of human rights and jeopardizing international peace and security is naïve at best,” he said.

Speaking at a press briefing that same day, Lazzarini told reporters, “We can only feel that the worst is yet to come.” He remarked that since January, aid delivery to Gaza has decreased by 50 percent. Since then, famine has become all but inevitable.

Remarking on the dual investigations into UNRWA’s operations, Lazzarini stated that the investigations were necessary as an accountability measure. These investigations were announced after it was revealed that he had terminated the contracts of 12 staff members who were allegedly involved in the October 7 attacks. Lazzarini added that the “swift decision” to terminate the contracts, as well as the investigations, would likely reflect the agency’s ability to follow through on recommendations from a risk management review.

Lazzarini admitted, however, that he had not anticipated the swift action that 16 donor countries took to suspend their funding in the wake of the allegations, which he revealed were conveyed to him in an oral manner.  “I have no regret,” he said, referring to his response to the allegations, “but to be honest, I did not expect that… over the weekend, 16 countries would take that decision.”

The UNRWA chief also indicated that most donor countries would consider resuming their support. For those donor countries, the pressure to pull support came from domestic or public opinion that seems divided over UNRWA rather than foreign policy considerations.

There is some promise that UNRWA will continue to deliver on its mandate with the help of donor states, as was seen with the European Commission’s decision to continue funding the agency, starting with a pledge of 50 million euros. However, this will only go partway into filling the gap of 450 million USD left by the 16 donor countries. Lazzarini warned that without additional funding, the agency would be in “uncharted territory” and would have “serious implications for global peace and security.”

The atrocities that were committed on and since October 7 have only resulted in increasing devastation and tragedy. The international community, as embodied by the General Assembly on Monday, seems largely united in their calls for a humanitarian ceasefire in Gaza and for the safe release of all hostages.

Yet the ongoing hostilities in the region have prevented the UN and its agencies from fulfilling their mandate to safely provide critical emergency aid. Five months on, there is a seeming lack of forward momentum within the Security Council to deliver a ceasefire resolution. UNRWA has been contending with compounding existential questions about its survival as an agency from hostile forces in the Gaza Strip and beyond who call for its dissolution.

IPS UN Bureau Report


Moimuna Nursing Institute Ushers Hope for Vulnerable Rural Girls in Bangladesh

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Active Citizens

Dr MA Sayed conducts a practical with his students at the Moimuna Nursing Institute. Credit: Rafiqul Islam/IPS

Dr MA Sayed conducts a practical class with his students at the
Moimuna Nursing Institute. Credit: Rafiqul Islam/IPS

THAKURGAON, Bangladesh, Feb 6 2024 (IPS) – After passing her secondary school certificate (SCC) in 2019, Sweety Akter went door-to-door to collect money to enroll in a college, but she wasn’t successful.

Born to an extremely poor family in Fultala village under Baliadangi upazila in Thakurgaon district, Akter saw her dream of studying fading as she was unable to enroll in a college because of a lack of funding, despite her good results at school.

“I went to many places but did not get the opportunity for admission. I did not have the financial support to study at a private college or an educational institute.”

Then Sweety’s fortune changed.

“I luckily got a chance to study for a nursing diploma free of charge at Moimuna Nursing Institute (MNI),” she told IPS.

Two sisters, Sweety Akter (left) and Shikha Akter (right) enrolled in Moimuna Nursing Institute, Sweety has already completed a nursing diploma with financial support from the institute and Shikha is now a second-year student. Credit: Rafiqul Islam/IPS

Two sisters, Sweety Akter (left) and Shikha Akter (right), are enrolled in Moimuna Nursing Institute. Sweety has already completed a nursing diploma with financial support from the institute, and Shikha is now a second-year student. Credit: Rafiqul Islam/IPS

Explaining her financial hardships, the 22-year-old Akter said her father is a gambler who had sold all the family’s assets to gamble, and he had even sold their lone homestead, where they are currently living.

“My father does not give me and my younger sister any money for education. My mother works as domestic help at the houses of people and is bearing the costs for our four-member family,” she said.

Sweety said that if she had not had the opportunity to enroll at MNI, it would have been impossible for her to pursue tertiary education, and she would have been forced to marry.

Overcoming all the odds and passing the nursing diploma, she is now pursuing an internship at Rangpur Medical College and Hospital (RMCH) with financial support from the institute, which paves the way for former students to get jobs at hospitals.

Shikha Akhter (19) enrolled in Moimuna Nursing Institute in Thakurgaon, northwest Bangladesh, to pursue a diploma in nursing science and midwifery with the encouragement of her sister, Sweety.

Shikha said she enrolled in the institute at a minimum fee, and now she is enjoying more facilities than other students as her elder sister also studied there.

“I am studying the nursing diploma and staying at the MNI’s hostel, which makes my life easy. I want to be a good nurse and serve people,” she added.

Joya Rani, a 20-year-old girl from poverty-stricken Kaliganj village under Deviganj upazila, also studied the nursing diploma with financial support from the institute.

“My father is physically challenged, so he cannot work. My mother is the only breadwinner for our family, and she supports the family by rearing cattle. That’s why she cannot give me any money (for study),” she told IPS.

Joya, who is currently doing an internship at RMCH, said she received a stipend of Taka 2,000 (USD 19) from the institute over the past two years, and if she had not received the stipend, it would not have been possible for her to continue studying.

Moimuna Nursing Institute, located 460 kilometers away from the capital Dhaka, is a non-profit approved by the Bangladesh Council of Nursing and Midwifery and offers a three-year diploma in nursing for about USD 1,500, which includes tuition fees, accommodation, uniforms, and books.

Thakurgaon is a poor district in Bangladesh, with a poverty rate of 36.7 percent against 18.7 percent at the national level. Of them, about 19.7 percent of people in the district live in extreme poverty, which prevents many from continuing their education, particularly the girls.

Since the start of its journey in 2019–20, the MNI has been providing financial support, including stipends and need-based scholarships, for students coming from underprivileged families.

MNI’s managing director, Dr. MA Sayed, said the institute authorities are providing a handful of scholarships, with three poor students receiving stipends in each batch so that they can continue their nursing education.

In distributing scholarships and stipends, a committee of the institute inspects the houses of their students. If the committee finds evidence of acute financial hardship, the MNI provides support.

Even after completing the nursing diploma, the institute’s support continues, and it facilitates sending the former students to public hospitals to do internships.

“During their internship, we are providing financial support for some selected poor students so that they can accomplish their goals,” Sayed said.

He said the MNI provides a residential facility for its students to ensure a smooth environment for education, resulting in a 100 percent pass rate, which makes it the first in Thakurgaon district.

“We also carry out career counseling for students to encourage them to consider a higher education in nursing,” he added.

Teachers, students and staff of Moimuna Nursing Institute pose for a photo in front of its main building on the campus. Credit: Rafiqul Islam/IPS

Teachers, students, and staff of Moimuna Nursing Institute pose for a photo in front of its main building on the campus. Credit: Rafiqul Islam/IPS

Nirmola Toppa, mother of Nila Kispotta, who recently completed a nursing diploma from the MNI, said after her daughter passed the SSC examination, she tried to marry her off because she could not afford to pay for her daughter’s educational expenses.

But a scholarship meant Nila could complete her diploma, and she is now getting a stipend of Taka 2,000 (USD19) per month from MNI to complete her six-month internship at RMCH.

Nirmala said Nila received Taka 6,000 (USD 57) to enroll in the internship too.

Founder of Moimuna Nursing Institute, Dr. Saifullah Syed, said in Thakurgaon, many rural underprivileged girls and those coming from minority and ethnic communities pass the entrance exam (SSC) to enroll in nursing institutes but do not enroll due to financial constraints.

Also, there are many who could qualify but do not take the entrance exam, thinking that they may not be able to afford the educational expenses to become nurses and midwives, he said.

“That’s why I founded Moimuna Nursing Institute to ensure that qualified poor rural girls, particularly those coming from minority and ethnic communities, get the opportunity to become nurses and midwives,” Syed told IPS.

He asserted that his institute has established an endowment fund under the control of a Board of Trustees, provides need-based scholarships, and arranges sponsors.

The MNI welcomes donations as it means more students may be assisted.

IPS UN Bureau Report


Smallholder Farmers Gain Least from International Climate Funding

Africa, Aid, Civil Society, Climate Action, Climate Change, Climate Change Finance, COP28, Development & Aid, Editors’ Choice, Food and Agriculture, Food Security and Nutrition, Food Sustainability, Global, Headlines, Human Rights, Humanitarian Emergencies, Sustainable Development Goals, TerraViva United Nations

Climate Change Finance

David Obwona at his seed rice farm in Katukatib village, Amoro district, northern Uganda. The farmer is part of a group that is now engaged in seed rice farming to climate-proof agriculture courtesy of the Regional Universities Forum for Capacity Building Agriculture. Credit: Maina Waruru/IPS

David Obwona at his seed rice farm in Katukatib village, Amoro district, northern Uganda. The farmer is part of a group that is now engaged in seed rice farming to climate-proof agriculture courtesy of the Regional Universities Forum for Capacity Building Agriculture. Credit: Maina Waruru/IPS

NAIROBI, Nov 14 2023 (IPS) – Smallholder farmers from the Global South benefit from a grossly disproportionate 0.3% of international climate finance despite producing a third of the world’s food and despite holding the key to climate-proofing food systems.

The family farmers and rural communities received around USD 2 billion from both public and private international climate funds out of the USD 8.4 billion that went to the agriculture sector in 2021, even as over 2.5 billion people globally depended on the farms for their livelihoods.

The USD 8.4 billion was almost half of the USD 16 billion that was availed for the energy sector and is only a fraction of the estimated USD 300-350 billion needed annually to “create more sustainable and resilient food systems,” a new report has found.

The amount was also quite different from the USD 170 billion that smallholder farmers in Sub-Saharan Africa alone would require per year, the study on global public finance for climate mitigation and adaptation conducted by Dutch climate advisory company Climate Focus has found.

The low level of climate finance for agriculture, forestry, and fishing is of concern, given the impact of climate change on food production and the extent to which food and agriculture are fueling the climate and biodiversity crisis.

Agricultural productivity has declined by 21 percent due to climate change, while the food and agriculture sector as a whole is responsible for 29 percent of greenhouse gas emissions and 80 percent of global deforestation, the study explains.

The farmers have been sidelined by global climate funders and locked out of decision-making processes on food and climate despite being the engines of rural economic growth. This is especially so in Sub-Saharan Africa, where up to 80 percent of agriculture is by smallholder farmers and where 23 percent of regional GDP is attributable to the sector.

It reveals that 80 percent of international public climate finance spent on the agri-food sector is channeled through governments and donor country NGOs, making it hard for smallholder farmers’ organizations to access it. This is because of complex eligibility rules and application processes and a lack of information on how and where to apply.

Many family farmers also lack the infrastructure, technology, and resources to adapt to climate impacts, with serious implications for global food security and rural economies as well, it notes.

The study ‘Untapped Potential: An analysis of international public climate finance flows to sustainable agriculture and family farmers,’ published on 14 November, laments that only a fifth of international public climate finance for food and agriculture supports sustainable practice. The money mainly goes to the Global North, even as agriculture becomes the third biggest source of global emissions. and the main driver of biodiversity loss.

“Climate change is hitting harvests and driving up food prices across the globe. It has helped push 122 million people into hunger since 2019. We need to create more sustainable and resilient food systems that can feed people in a changing climate, but we can’t do this without family farmers,” the report compiled on behalf of ten farmer organizations in Africa, Asia, Latin America, and the Pacific says.

“Family farmers are also key to climate adaptation. They are at the forefront of the shift to more diverse, nature-friendly food systems, which the Intergovernmental Panel on Climate Change (IPCC) says is needed to safeguard food security in a changing climate,” it further notes.

The groups are led by the World Rural Forum and include African groups—the Eastern Africa Farmers Federation, Eastern and Southern Africa small-scale Farmers Forum, the Regional Platform of Farmers’ Organisations in Central Africa, and the Network of West African Farmers’ and Producers’ Organisations. Also part of the group is Northern Africa’s Maghreb and North African Farmers Union.

The Asian Farmers Association for Sustainable Rural Development, the Pacific Island Farmers Organization Network, the Confederation of Family Producers’ Organizations of Greater Mercosur, and the Regional Rural Dialogue Programme are also represented in the study.

Many of the farmers are already practicing climate-resilient agriculture, including approaches such as agroecology, which implies a wider variety of crops, including traditional ones, mixing crops, livestock, forestry, and fisheries, while reducing agrochemical use, and building strong connections to local markets.

The study by the new alliance of farmer networks representing over 35 million smallholder producers ahead of COP28, which is set to agree on a Global Goal for Adaptation, is concerned that since 2012, overall, only 11% of international public climate finance has been targeted at agriculture, forestry, and fishing, which amounts to an average of USD 7 billion a year.

In 2021, the World Bank, Germany, the Green Climate Fund, and European Union institutions contributed around half—54 percent, amounting to USD 4 billion collectively, while Nigeria, India, and Ethiopia were the top recipients, receiving a combined USD 1.8 billion. Notably, some of the world’s most food insecure countries, including Sudan, Sierra Leone, and Zambia, each received less than USD 20 million, it discloses.

“As the climate crisis pushes the global food system ever closer to collapse, it is vital that governments recognize family farmers as powerful partners in the fight against climate change,” it warns.

Hakim Baliriane, Chair of the Eastern and Southern Africa small-scale Farmers Forum, observed: “Climate change has helped push 122 million people into hunger since 2019. Reversing this trend will not be possible if governments continue to tie the hands of millions of family farmers.”

The study defines small-scale family farms as those of less than two hectares, mainly in developing countries.

On the other hand, international climate finance broadly refers to finance channeled to “activities that have a stated objective to mitigate climate change or support adaptation. These include multilateral flows in and outside the (UNFCCC) and the Paris Agreement, as well as bilateral flows at national and regional levels, including the Global Environment Facility, Adaptation Fund, and Green Climate Fund, and are usually disbursed as grants and concessional loans

The study finds that family farms are also the backbone of rural economies, supporting over 2.5 billion people globally who depend on family farms for their livelihoods. It says that in Sub-Saharan Africa, where up to 80 percent of farming is done by smallholder farmers, agriculture contributes 23 percent to regional Gross Domestic Product.

Family farmers are also key to climate adaptation in that they are at the forefront of the shift to more “diverse, nature-friendly food systems,” which, according to the Intergovernmental Panel on Climate Change (IPCC), are critical in safeguarding food security in a changing climate.

It finds that millions of smallholder farmers are already practicing climate-resilient agriculture, including approaches such as agroecology—growing a wider variety of crops, including traditional crops, mixing crops, livestock, forestry, and fisheries, reducing agrochemicals use while building “strong connections to local markets.”

It concludes that governments must ensure that available climate finance for sustainable climate-resilient practices is increased, including that of agroecological approaches.

It explains: “This means funds to support diverse, nature-friendly approaches and to create community-based solutions that build on traditional expertise and experience.

It recommends that small-scale family farmers ought to have direct access to more climate finance and that financing mechanisms and funds should be developed with the participation of farmers’ organizations to meet their needs.

In addition, efforts should be made to ensure longer-term, flexible funding so that communities can determine their own priorities.

The role of the farmers as powerful catalysts for climate action, food system transformation, and the protection of biodiversity should be acknowledged and given a “real say” in decision-making on food and climate at the local, national, regional, and international levels. This should include decisions on land reform and agricultural subsidies.

The COP28 in Dubai later this month has food systems as a big part of the agenda.

An August report by the UK’s ActionAid has found that climate adaptation and green transition initiatives in the Global South received 20 times less financing when compared to main global emitters, fossil fuels, and intensive agriculture sectors in the last seven years.

It found that leading banking multinationals funded the emitters’ activities in the southern hemisphere to the tune of USD 3.2 trillion since 2015 when the Paris Agreement on Climate was adopted. German agrochemical giant Bayer was the biggest recipient of the financing, receiving an estimated USD 20.6 billion since 2016.

IPS UN Bureau Report