Archives For children at risk

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I recently spent some days in Mumbai with our team there who are working to establish what will be a critical collaborative voice to help combat child sexual abuse (CSA)  in India.

Aarambh will be in first order a National Resource Centre on child sex abuse and, at the same time, will have the capacity to access legal and other support for victims, as well as provide training to communities, relevant government bodies and NGOs on the topic. The Resource Centre, which will gather education materials, promote awareness and best practice, is scheduled for launch in November.

Aarambh is a joint initiative of the ADM Capital Foundation and Mumbai partner, Prerana, which for two decades has provided support to the children of sex workers and is led by Priti Patkar, who is a respected authority in the field.

We are extremely excited to have Prerana as our partner in building Aarambh in a country where a 2007 government-sponsored study that included 12,500 interviews with children in 13 Indian states said 53 percent reported having been sexually abused in some way. Only three percent of the cases were reported to the police.

Last year, a Human Rights Watch report said the government’s response to CSA has fallen short, both in protecting children and in treating victims.  At the time the HRW report was released, Meenakshi Ganguly, the director of Human Rights Watch in South Asia, said in a statement: “Children who bravely complain of sexual abuse are often dismissed or ignored by the police, medical staff and other authorities.”

The government did not dispute HRW charges that India’s child protection system was flawed. The head of one government agency was quoted as saying at a news briefing that frequently police or court officials didn’t accept that rape or incest had occurred.

Besides Prerana’s deep knowledge of CSA in India, Aarambh builds on ADMCF’s long partnership with Philippines-based Stairway Foundation, which has produced excellent training materials and animated films on such topics as incest, trafficking and sexual abuse more generally.

ADMCF helped Stairway foundation translate the films and other materials into several Thai languages and facilitated trainings of NGOs and other groups there before turning most recently to India, where education, discussion and action on the topic is equally critical. The moment for change seems particularly right given India’s two-year old law on CSA known by the acronym POCSO. There exists confusion related to how to implement that law nationwide.

Uma Subramanian, who has led ADMCF in India over the past few years, is leading Aarambh with Prerana. She is building a team and the network of partners that will form the initiative. Indeed, the vision for Aarambh is that it is a collaborative effort, bringing together organizations working on the topic of child sex abuse from many perspectives, beginning with the Mumbai Child Safety Network.

In terms of helping to implement the law, for example, there ought to be specific medical units within hospitals set up to receive children who have been victims of abuse. There also needs to be training and special provision within the courts and police force nationally. At the same time, there will be space to comment on aspects of the law to make sure it functions effectively to protect children.

Some of this work is ongoing regionally, but the Aarambh National Resource Centre hopefully will help to spread best practice throughout the country.

Among Asia’s most discriminated people are the Rohingyas. About 1.33 million of the Muslims of South Asian descent live in Myanmar, where all but 40,000 are stateless. Myanmar’s 1982 Citizenship Law considers Rohingyas illegal Bengali immigrants – despite the fact that many have lived for generations in the western state of Rakhine, which borders Bangladesh.

Fortify Rights, a human rights organization, said recently in a new report, Policies of Persecution , that restrictions placed on Rohingyas by the Burmese government are presented officially as a response to an “illegal immigration” problem and threats to “national security”. Yet Rohingyas as a group live in unimaginable poverty due to deprivation and displacement.

Since 2012, with easing of political restrictions in Burma, there have been several bouts of violence between the Rohingya and the Buddhist ethnic-Rakhine, who claim to feel threatened by the muslim population. Both sides have sustained casualties in the fighting but, according to Fortify rights, several hundred men, women and children have been killed and muslim communities razed.

As a result, tens of thousands of Rohingya now live in crowded camps in Burma, Bangladesh, Malaysia and Thailand, where they haven’t faired much better.  Just to reach their new destination, they risk death at sea in overcrowded and unstable transport arranged by human traffickers who take advantage of their poverty and statelessness, often forcing them into bonded servitude.  Killings and other ill-treatment is also not uncommon, Fortify Rights and others have said.

The most recent example of egregious discrimination against Rohingyas started with the latest census, data collection for which began on March 30th. The census, however – a first since 1983 for the population estimated at 60 million – makes use of a list of 135 recognized nationalities yet excludes Rohingyas. Initially, they were told they could write in their ethnicity but later the government backtracked and said they should self-identify as Bengalis, according to news reports.

This census simply compounds what is already an untenable situation in Burma for the Rohingya population, which suffers Burmese policies that Fortify Rights describes as, “designed to make life so intolerable for Rohingya that they will leave the country.”

Among the restrictions enshrined in state policy that the Rohingya face in Burma are those on movement, Fortify Rights said in its report. They cannot travel within or between townships without authorization and only under exceptional circumstances travel outside the state, according to 12 internal government documents obtained by the rights group. Among other restrictions are those relating to marriage, childbirth, home repairs and construction of houses of worship. There are severe criminal punishments for Rohingyas who  violate restrictions, including often years in jail and fines, according to Fortify Rights.

The report calls for the Myanmar government to abolish its discriminatory policies and accord Rohingya full rights under Burmese law, including the right to protection from violence. The international community should not sit by and watch the persecution of Rohingya ahead of next year’s critical election when the military generals are expected to cede power. All Burmese, regardless of ethnicity, should share in the government’s promised reforms.

 

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Always the challenge for an organization working with marginalized children in Asia is how to really alter an existing imbalance – for example to provide education or skills to working children otherwise deprived of learning and a childhood in a way that will make a meaningful difference to their futures.

It is not so complicated to establish an educational program or direct children into government schools – when these exist or there are places. There is real desire among those for whom education is not a given, to live the dream and to learn.

But even when education can be made a reality, it is often not enough to just put children in school, or sit them in front of a blackboard and teacher for a few hours a day. There are so many factors that act against the instinct to learn: lack of food or safe drinking water, cold weather when children don’t have enough clothing, hot weather when they must learn outside or in rooms without windows, absence of sanitation and healthcare, little support from parents, and family pressure to work, among them.

In India, where, along with support from a UK-based partner, ADMCF has been working with a local organization to encourage children out of what is often hazardous work and back to school, the challenges for learners are myriad.

The NGO works with marginalized urban populations in the worst conditions imaginable. The problem remains: can it offer education without thinking about nutrition, healthcare, encouraging family support (not financial) and expect permanent results in the children’s lives? Can we expect, particularly in the most challenging communities that access to education alone will lead to a better future?

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This has been particularly true in the wake of India’s well-intentioned Right to Education Act, which determined in August 2009 much as the name suggests that all Indian children should be in school from 6-14.

This meant that our partner organization, which had established drop-in centres as way stations between work and school, was forced to rethink how it worked with children who had never attended school or had dropped out years previously.

Instead, after a brief transition, all children had to be quickly enrolled in government school, whether they were ready or not. They no longer had the luxury of longer preparation in a safer environment ahead of enrollment.

This was tricky enough in major urban areas, where there were schools and places and children could be supported in after-school programs in the same centres. But in the poorest urban slums in India that are home to significant Dalit or untouchable populations (many migrants from rural areas), there are often no government school options – despite the fact that according to official statistics, 96.6 per cent of children in India ages 6 to 14 are now enrolled.

IMG_5184If there are schools, there are no places. If there are places, the classes are massively overcrowded or there is discrimination against Dalits. If there is no discrimination, the teachers don’t show up for class. In any case, for the poorest children, there frequently is little learning to be had in official schools.

Enter our partner NGO, which provides that stepping stone to education but faces the many questions above. They now must mainstream their primary and secondary school children into schools that don’t exist, or where they don’t learn. Their own centres must not be schools. So what is the learning path?

For a child with enough money there is a proliferation of private schools stepping into the lacunae created by failing government education. But how does an education NGO step in to provide support to ALL marginalized children, not just the brightest, how does it make sure that all children it contacts receive the education to which they are entitled under Indian law yet can’t access?

Then, at the same time, how does an organization in a country as vast as India, where marginalized children are easily discarded by law and society, provide the conditions for learning given limited resources and India’s education act?

Clearly, there should be more provisions made to support education for India’s poorest children, particularly in a country that traditionally has placed such value on learning.

 

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Angkor Hospital is the spectacular facility in Siem Reap, Cambodia I have written about in previous blog posts. Last year, the hospital offered 157,000 treatments to children free of charge, ranging from physical therapy and dental care to heart surgery. The boy above is an AHC heart patient who prior to surgery could hardly walk. When I came across him with his mother in the packed waiting room – back for a check up – he was running across the courtyard. His mother wanted to show me his scar.

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The hospital includes an incredible team of 49 Cambodian doctors and 149 Cambodian nurses, not to mention an equally dedicated support staff of 130. Although foreign teams do sometimes assist and train in more complicated procedures, there are only two full-time foreign doctors and two full-time foreign nurses at AHC. Above is the ER team comparing notes on patients.

The AHC budget for this year is US$4.5 million U.S., which works out to a cost per child of US$23. This compares to an average cost per child in the U.S. of US$1,853. Throughout this year, an average of 1,400 children were visiting the Emergency room at AHC and its satellite clinic thirty kilometers away, while 290 patients required admission. On average, the hospital’s three surgeons performed seven surgeries daily.

Those numbers have increased over the past few months, however, with a regional dengue outbreak and a larger number of patients seeking quality medical care they can’t find or afford elsewhere. In some cases, patients have had to rest on mats in the corridor for lack of ward space, while others have been sent to other hospitals.

A new four-floor building is now under construction. This will help improve medical care and create an additional 250 sq meters in the main hospital. Among the additions will be a neonatal ward, a new ward for recovering children, an expanded ER and labs (including the research lab, which is a partnership with Oxford University). Beyond the recent pressure from larger numbers of patients, an April medical audit identified a lack of adequate space, the small ER and lack of neonatal unit as the top three weaknesses of AHC.

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AHC works hard to provide the quality of medical care and compassion that a sick child would receive in a developed world context. The type of treatment offered at AHC, which is free of charge, is rare in Cambodia. This includes support to chronically ill patients, physiotherapy and palliative care for very sick children.  A home care program follows up with many such patients and includes a social work team.

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Some patients and their parents who aren’t able to see a doctor on the day they arrive must wait until the next day. The hospital provides cooking facilities, clean water and mosquito netting, which, innovatively, is tied between benches in the waiting area.

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These two children were waiting with their mother and a sick sibling, who needed medical attention.

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Beyond providing medical care and support to government hospitals around Cambodia in developing their medical and nursing protocols, AHC helps educate communities about issues related to health care. Some of the main causes of sickness, the main reasons that patients end up at AHC’s gates, are drinking contaminated water, poor sanitation and poor nutrition. In the context of working in one of Cambodia’s poorest regions where malnutrition is surprisingly still rife, AHC staff teaches children and their families the basics to keep them healthy.

I recently spent a week at Angkor Hospital for Children in Siem Reap, Cambodia with Francesco Caruso, director of ADMCF’s Children at Risk program and Ryan Glasgo, our new finance director. Both are working hard to help bring the hospital to the point where it can become a fully Cambodian institution.

When the hospital was founded in 1999 by Japanese photographer Kenro Izu and then was nurtured into being in partnership with an American board as a free pediatric hospital, Cambodia was a very different place.

Now there is a growing middle class, many of whom would be fully able to pay something for medical care. AHC for now, however, is still entirely free to any Cambodian child.

At the same time, the hospital in 2012 has a talented and dedicated medical and administrative staff that is fully capable of taking the hospital forward.

There is now an almost entirely Cambodian staff of 149 nurses and 46 doctors, including AHC’s executive director. Only two doctors and two nurses are foreign.

Last year, the hospital treated more than 150,000 children for illnesses ranging from acute diarrhea to tuberculosis. The Outpatient Department sees between 400 and 600 patients daily, while the Inpatient unit of 40 beds is almost always full.

An emergency room has eight beds, four of these in a separate isolation ward. There are plans to build a separate neonatal ward since on any day 10 of the patients are babies and many have suffered birth trauma or are premature.

Surgeries in the one operating theatre range from hernias to heart repair.

A pediatric Satellite clinic that is part of the government hospital in Sotnikum, 35 kilometers from Siem Reap, last year treated 12,300 Children. The Satellite staff works closely with the government hospital to build the quality of care offered there, with a focus on assisting the lab, X-ray unit and pharmacy, which the clinic shares. The clinic also has  installed an emergency button in the delivery room to summon a Satellite  doctor to assist any baby in distress.

AHC  also has become northern Cambodia’s premier pediatric teaching facility. The Medical Education program includes a three-year residency program for every doctor who joins and then on-going internal education and fellowships abroad.  ME also offers internships and trainings  for medical staff  from other hospitals.

“What we are developing is to be shared,” the hospital’s executive director, Dr. Bill Housworth emphasized, explaining the hospital’s full engagement via the AHC External Program with both the Ministry of Health in Phnom Penh and directly with many of Cambodia’s government hospitals.

The AHC Capacity Building program works with rural Health Care Centres and communities to provide education on nutrition, hygiene, sanitation and relevant disease – some of the main challenges for the AHC patient population.

The hospital, Satellite, Medical Education and  CB programs together cost US$4.5 million last year. This amount is covered almost exclusively by donor funding and is a challenge for the hospital to raise each year.

Consequently, AHC is of necessity looking at revenue-generating programs and already for a fee provides hospital services to the children of some local NGO workers and airport staff in Siem Reap.

Although public hospitals are not free in Cambodia, about 30 percent of the rural population has what is known as a Health Equity Card, which establishes that they are poor and reimburses some of the medical costs and travel expenses to get to the hospital. But even then, it is not uncommon for doctors and hospital administrators to ask patients for payment ahead of treatment.

Private clinics are expensive and don’t necessarily provide a better quality of care, underlining the importance of a hospital like Angkor for the population that just cannot pay medical costs.

Research shows that the most common reason for impoverishment in Cambodia remains emergency healthcare costs, which force families to enter an often unending spiral of debt. For families who have a child with a chronic disease, healthcare costs can be devastating.

In Cambodia, an average of one in 20 children die before their fifth birthday, compared to a rate of one in 120 found in developed nations, according to UNICEF. And four children out of five live in rural areas, where the mortality rate is much higher at 64 deaths per 1,000 live birth.

Government census data shows that in 2010, 40 percent of children under five were too short for their age, stunted by malnutrition. Roughly 30 percent of Cambodians live on less than $1.25 per day, which the World Bank has established as the poverty threshold.

Indeed, Siem Reap province, better known abroad for its 11th century temple complexes and lavish hotels replete with Western tourists, has the third-highest poverty rate among the Cambodian provinces at 52 percent.

For a province of 1 million people, the total health budget of Siem Reap this year is about $2.8 million, according to provincial health officials, and almost two-thirds of that represents support from large foreign government donors.  None of that makes its way to AHC.

Clearly, part of the problem with provincial hospitals is that the government can afford to pay only low salaries to its health workers. Thus doctors, who might earn as little as $100 a month, often supplement their incomes with private clinics that take precedence over any hospital care.

Still, Cambodia is making headway in medical care on offer, in part with the support of AHC.

Part of the problem is the legacy of destruction leftover from the 1975-1979 Khmer Rouge rule, when medical professionals and other educated people were singled out for slaughter. In all, an estimated 1.7 million people were killed or died from forced labor, starvation or disease over the period.

When they marched into Phnom Penh and other cities, the Khmer Rouge emptied the hospitals, eliminated the doctors and then left the care of sick and injured to untrained young soldiers who favored traditional Cambodian remedies over Western medicine.  By the time the Vietnamese ejected the Khmer Rouge from power, there were only an estimated 40 doctors left in the country.

Decades of war and isolation followed, leaving the medical infrastructure in shambles. In the 1990s, NGOs simply took over the health care system without trying to build anything indigenous, and change only began in earnest with the end of the Cambodian Civil War in 1998.

Angkor Hospital is working hard to be part of the solution.

I keep hearing about how expensive sustainable fashion inevitably is and that since we are used now to so-called fast fashion, it’s just not practical to think we will easily give up cheap apparel. But is greener fashion really more expensive? And how can we educate consumers  on this topic? These were two issues discussed during a panel I moderated last week as part of the Redress Forum in Hong Kong.

Among other featured topics during the day of presentations were, the business of sustainability, eco-labelling, best practice and inspiring the next generation.  The sense after a day of conversation was that there is still far to go in terms of really producing apparel that is truly sustainable for a mass audience and that the myriad eco-labels are often confusing to the buyer, designer AND the consumer.

In terms of waste, there is little that helps a consumer understand the recycled content of clothing and Hong Kong-based Redress announced it was introducing a new consumer-directed label that would help. A major fashion brand will be introducing this label shortly along with a new eco collection that includes a high percentage of recycled textiles – an exciting development here!

Although in the UK, for example, the sense among younger designers is that sustainable is the future, in Hong Kong, whether to wear fur even in summer seems more of a concern than sourcing green clothing, according to HK Tatler fashion editor, Arne Eggers. In the land where luxury is king and brands are everything, even the Tatler Green issue struggles for advertising, he said.

Still, also on my panel, “Educating and Engaging Consumers” was Tobias Fischer, regional CSR  manager Far East for H&M and he said that for his company sustainable equalled cost-saving. He became irritated every time sustainable fashion was described as more expensive, pointing out that sustainable involves saving costs on energy, water, chemicals, textiles etc.

“Current manufacturing is not factoring in the true cost of production,” said Filippo Ricci of UK’s From Somewhere and co-founder with Orsola de Castro of Estethica, established five years ago to showcase young designers committed to working eco sustainably as part of London Fashion Week.

And of course he’s right. In developing nations with few enforced regulations, the factory dying process causes untold damage to rivers and downstream populations when waste is simply pumped into waterways. Meanwhile, excessive chemicals used to grow cotton pollute the topsoil, groundwater and again damage the health of agricultural workers.

Heavy use of energy, often from coal, to produce apparel that satisfies our seemingly uninsatiable appetite for clothing means power plants must pump out waste emissions that pollute our air. Excessive consumption of water, particularly in already water-scarce regions (many of these in China) further limits supplies for future generations.

With consumption of clothing 60 percent higher over the past decade and the cost of clothing lower than ever, it just is not realistic to think that factories can continue to pump out product that doesn’t factor in any of the social or environmental costs of production. Already, with labor prices in China rising as living standards improve and regulation there tightens, inevitably costs  even of fast fashion will have to rise.

Meanwhile, however, many brands are simply taking their business elsewhere – looking to Vietnam, the Philippines and Indonesia among others to maintain the rock bottom prices we have come to expect, particularly from discount stores such as Target and TJ Max in the U.S.

ADMCF recently spent time in Patna, in India’s Bihar state where we were looking at how we might work effectively with the Musahar community, which ranks at the bottom of the dalit or untouchable caste.

We found that there is apparently relatively little concrete information about or assistance given to the Musahar, whose name translates quite literally as the “rat-eaters.” Estimates of their numbers in Bihar and other states range from 2 million to as high as 5 million.

The Musahar fall so far down the well of the Indian caste system that by all accounts its people live in modern India much as they did 2,000 years ago. In an initiative that was perhaps telling about the regard in which the community is held, in 2008 the Indian government acted to help the Musahar by allowing the commercialization of rat meat.

A brief portrait of their situation gleaned from what is available online and through conversations in Bihar: In the villages around Patna in Bihar state, India, child marriage at 13 or 14 is still common, although illegal in India.

In the rural areas, Musahar are primarily bonded agricultural labourers, but often go without work for as much as eight months in a year.  Children work alongside their parents in the fields or as rag pickers, earning as little as 25 to 30 rupees daily.

The Musahar literacy rate is 3 percent, but falls below 1 percent for the women. Yet it is cast discrimination rather than parents that keep Musahari children away from schools. That said, the schools to which they have access apparently offer so little in the way of education that perception among the community is that schooling doesn’t offer them anything. And it is certainly true that even if they do manage an education certificate, discrimination means few manage to find jobs anyway.

By some estimates, as many as 85 percent of some villages of Musahars suffer from malnutrition and with access to health centres scant, diseases such as malaria and kala-azar, the most severe form of Leishmaniasis, are prevalent.

Besides eating rats, the Musahars are known for producing a good and cheap alcohol so not surprisingly alcoholism is rampant among the community, particularly the men.

Government development programs provide very little support to the Musahars. They are not recipients of housing schemes because generally they do not possess title deeds for their land. They are also the lowest number of recipients of loans from revolving funds within government schemes.  Thus the social support system bypasses them, as do private donations since so little is known about them.

The Dalit community in Bihar as a whole suffers frequent and often unpunished human rights violations. In the ten years before 2003, for example, 4243 cases of Dalit atrocities were registered in police stations, including 694 cases of murder, 1049 of rape, 1658 of severe injury and 842 cases of insult and abuse.

Into this picture walked Sudha Varghese 26 years ago, a nun who wanted to give voice to India’s dalits. The Musahars were the least advantaged of the dalits she could find and she moved into their community to truly understand their needs and way of thinking.

her organization, Nari Gunjan, was born to give voice to the Musahar women in particular. The organization now runs 72  primary education centres and a residential hostel/school for girls. Nari Gunjan promotes social, political, and economic empowerment for the women and girls. Beyond education, some of the centers provide vocational training and assist with micro-credit for Musahar women.

A decade ago, recognizing the need also to represent Musahar women in the courts, Sudha sent herself to law school and returned armed with a new skill set she has used to pursue the prosecution of ten rape cases that without her would have gone unpunished. In each case, she lead a column of Musahar women to the police stations to persuade officers to make the right arrest and in each case she has succeeded in putting the perpetrators behind bars, she says.

Known as the “bicycle nun” Sudha visits the various communities on her bicycle, and her fragile appearance belies a ferocious determination to provide Musahar children with education, self-esteem and purpose, its women with hope. For her courage, India’s national government recently awarded Sister Sudha the country’s highest civilian award, the Padmashri.

During a visit, the difference between children who attend her education centers and those who don’t was immediately apparent. Still, like any organization working in difficult circumstances that has been around for some time, achieving a constant flow of funding, even at the modest scale Nari Gunjan requires, is extremely hard. Some of the education centers have gone unfunded for 10 months although the teachers continue to work and the children appear.

An estimated 50,000 children of refugees from Burma live in the Mae Sot area of Thailand,  80 percent with no access to schools. Among them are children from the Mon, Karen and Shan minority groups fleeing decades of political, economic and military oppression at home.

These migrant populations along the Burmese border are largely forgotten, subject to harassment and have little access to support or education.

Estimates are that with a near absence of economic, educational, health and job options at home, about 2 million Burmese have migrated to Thailand since 1988.

Of these, 150,000 are living in refugee camps, 500,000 are legal migrants and the rest live illegally in Thailand.

Although the camps and borders are officially closed, an estimated 1,000 people cross into Thailand daily and this was evident on a recent visit to Mae Sot, with fighting raging just across the border.

Life for migrant Burmese in Thailand, however, is not much better than at home.  In a report released last year, Human Rights Watch described “an atmosphere circumscribed by fear, violence, abuse, corruption and intimidation for illegal Burmese in Thailand.”

The illegal migrants are kept to just a few low-skill job opportunities.  Most work as day labourers with no rights, no protection. They are commonly exploited and abused by employers, police, immigration and others with little recourse, according to HRW.

Schooling options for their children are also limited. Places for them in local Thai schools  are almost non-existent, although there are some limited Burmese “education centres” as the Thai government prefers to call them.  

In the Mae Sot area, Ashoka fellow Naw Paw Ray has worked hard to get Burmese children into some sort of schooling over the past 11 years. Of the 50,000 locally, she estimates 12,500 attend the  60 education centres, as they are called by the Thai government, gathered under her Burmese Migrant Workers Educational Centre network.

BWMEC works to make sure the curriculum and facilities of the education centres under her umbrella are adequate for learning, providing training, funding, administrative support and school buildings or dormitories where necessary.

A migrant herself, Paw Ray’s story is fairly typical of the migrant Burmese community. She left Burma  in 1986 when her village was destroyed by soldiers and entered a refugee camp in Mae Sot when they were set up by the United Nations a year later.  

In Burma, Paw Ray was a teacher but in Mae Sot she worked in a gas station until she said she could no longer stand to see the discrimination. “I could teach and I wanted to teach. I wanted to do something to help my people,” she said, setting up a first school with just 25 Karen and Burmese students.

Chosen as an Ashoka fellow in 2007, Paw Ray said that in her work she hoped to address the vast educational gap between Thai children and the children of Burmese migrant workers.

Naw Paw’s schools hopefully give migrant children options – preparing them for a prospective return to Burma or integration into Thai society and culture – critical to establishing a pluralistic and tolerant Thai society. The idea is to pave the way for migrant schools, students, and teachers to gain public support and official accreditation in Thailand.

No other organisation in Thailand fields such an array of minority schools or is doing so much to build a long-term solution to the growing number of uneducated migrant children coming to or born in Thailand each year.

Yet like many good organizations, Paw Ray struggles to find adequate funding to support this forgotten community.

And the problem remains, children attending the Burmese elementary schools have only limited access to Thai secondary schools for reasons related to cost, discrimination and availability.  That limits future job opportunities and integration.

So Paw Ray’s challenge remains: what is the best way to provide education to a migrant population that may or may not return home ?

 

We recently hosted a forum with the Asia Foundation on Philanthropy and Climate change.  We hoped to encourage Asian funders to draw the lines between climate change (something that seems often hard for the individual to grasp) and the more tangible and immediate air pollution, forestry degradation, water scarcity etc.

We also hoped to then get them to think beyond the environment to a wider philanthropic portfolio and to consider the impact of climate change on livelihoods, health, education – even how funders in the arts might get involved to build awareness around the need to act.

Why? We feel that given the enormity of the problem, it’s often hard for the individual funder, the family office foundation, to see how they might act in any way that is impactful.

But what we found was remarkable energy in the room. Rather than despair, we felt that participants left informed and energized by our panelists and keynote speaker, Stephen Heintz of Rockefeller Brothers Fund, which has an excellent environment and health, southern China program, managed by Shenyu Belsky.

Dr. James Hansen, one of the world’s leading climate scientists and head of the New York’s NASA Goddard Institute for Space Studies, provided an overview of climate science – setting the scene for discussion. Dr. Hansen, an advocate for a carbon tax, spoke of our inertia in the face of an emergency, the possible extermination of species, receding glaciers, bleaching of coral reefs, acidification of the ocean, basically that we are a planet out of balance.

Heintz also spoke about urgency, describing climate change as a “planetary threat that knows no bounds.” He emphasized the particular threat in Asia – that of 16 countries facing extreme risk, five are in in this region and they are among the most impacted, low-lying Bangladesh for example.

In all, he said, global warming could cost southeast Asia 6-7 percent of GDP. Clearly, Asia is squarely at the intersection of climate and development and he emphasized the need for new ideas and new ways of thinking, something that accurately reflects current realities and anticipates new needs.

It is easy, Heintz pointed out, to be discouraged by the science, yet philanthropy, government, civil society and the private sector all have roles to play. In reality , it is imperative that we act because, inevitably, climate change will impact every other issue that we are working on.

Global grant-making, Heintz said, has increased dramatically over the past decade yet environmental issues are way behind, receiving only 5 percent of funding. Resources targeting climate change specifically, of course, are far less.

The philanthropy sector, Heintz said, can play a crucial catalytic role, take risk, experiment, support advocacy to change public policy and trigger larger systemic change. Important will be innovative public-private partnerships, helping to develop emerging models of low-carbon prosperity. His was an excellent speech.

Our three panelists, Runa Kahn of Bangladesh’s Friendship, Dorjee Sun of Carbon Conservation and John Liu, an environmental filmmaker and journalist based in Beijing, spoke of the practicalities of working effectively within this context – and they also were inspiring.

Runa spoke about making life possible for the 4 million people living  in impossible circumstances in Bangladesh’s northern chars, John Liu on a massive ecological restoration project in China and showed the results, Dorjee on carbon, community and market solutions for saving forests.

The entire session was expertly moderated by the Asia Business Council’s Mark Clifford who managed to draw together the discussion, keeping an often amorphous and difficult topic moving toward practical solutions and away from fear.

The forum was a private side event to the C40 Climate change conference early this month organized by the Civic Exchange and supported by the Hong Kong government and Jockey Club Charities Trust.

It would be great to hear about other experiences linking climate change with a wider philanthropic portfolio, about nudging funders into action in this arena.

M’Lop Tapang is a remarkable organization. I’m reminded every time I visit. When I’m in Sihanoukville, I’m also reminded why I do my job. To be able to witness the incredible growth and impact of an organization like MT is truly a privilege. It gives me hope that we can help chip away at poverty and improve the lives of some of the world’s most challenged kids.

MT now works with 2,500 street and slum kids in the community, keeping them safe from abuse, getting drop-outs back into school, providing educational support to all, regular meals, healthcare, counseling and vocational training. There are night shelters for those without homes.

The committed staff works with the community, police and judiciary to make sure local authorities understand the challenges kids face working or living on the streets and educating them about pedophilia, which sadly is rife in Cambodia. As a result, the instances of kid abuse in the community have fallen and when pedophiles are caught they are much more likely to be kept in jail rather than being allowed to bribe their way to freedom.

As the M’Lop, or Umbrella tree, provides shade , M’Lop Tapang provides similar protection to Sihanoukville’s most vulnerable children.

I’m always struck by the surprising joy at MT, reflecting the resilience of the children, many of whom have suffered abuse, looked after an extremely sick or dying parent, or supported a whole family collecting cans or begging. There has not been much of what we would consider a childhood in these young lives – until M’Lop Tapang. The happiness, the determination to learn, is palpable walking around the centre, full of classrooms of attentive and enthusiastic kids. This is their place.

Most children participate in the arts and sports programs, which help foster the evident self-confidence in this lucky crew of kids. The arts of course also help them express themselves and learn new skills.

The arts program  includes amazing citywide carnivals and educational shows. This week, for example, MT kids, led by the amazingly dedicated Bob Passion and his Cambodian team, will be putting on a show for the Sihanoukville community on traffic safety. Other topics have been child safety, hygiene, recycling among many others.

MT kids also play team sports and the football team, well-attired in clean uniforms, travels to games. And believe me, they play to win!

The outreach program is large and amazing, with teams of social workers spending close time in the town’s poorest communities, taking education and healthcare to kids who can’t make it to MT’s day centre. They support children and their families through problems that, unresolved, hinder school attendance.

The baby program at the main M’Lop Tapang centre allows girls who otherwise might have to stay home to look after siblings, to bring them to MT, where they are cared for by a dedicated staff. The program also represents a safe place for very young children who have no other or inadequate care during the day at home.

Maggie Eno, a former British/Irish nurse, and Khmer friends began M’Lop Tapang in 2003 after watching local people and foreign tourists prey on children on the beach. What began as an initiative to feed six children under a large M’Lop tree and talk to them about safety quickly blossomed into  a wider program for about 250 by the time we met MT in 2006.

It has so inspiring to watch Maggie and her team, now led by Sarin, develop MT’s programs, broaden the services provided to street children and grow into the successful organization it has become.

In 2007 we built a new centre for MT and this year that was almost doubled in size to respond to growing need. The new wing houses more classrooms and an expanded clinic. Hong Kong medical Practice, Owens & Trodd has been great in providing on-going support and counsel to the MT medical team.

The MT staff now numbers 150 and are almost exclusively Khmer with the departure of MT’s American nurse, Hannah and also American Kate, who had helped with reporting, newsletters as well as other development work.

Francesco Caruso, who worked with Maggie near the beginning of MT has run the ADMCF children at risk programs from Hong Kong over the past few years. He helps raise funds for MT and others, as well as providing ongoing strategic support.

The rapid and solid growth of MT has involved so much dedication on the part of the hardworking staff as well as the  financial support from a diverse funding base that has allowed that to happen: DFID, several foreign embassies in Cambodia, Sovereign Art Foundation, Deutsche Bank Asia Foundation, the R.P. Haugland Foundation, Planet Wheeler, International Childcare Trust, to name just a few.

Visiting with Maggie in Sihanoukville we talked about the next phase of MT’s development being about building in greater sustainability where that is possible. Already, each of the vocational training programs are small businesses.

Working with Gustave from Phnom Penh-based Friends International, an excellent social enterprise, MT plans to develop over the next year a vocational training restaurant inspired by Friends’ own in the Capital. Friends, or Mith Samlanh, which is the local organization, is able to generate significant revenues from its excellent restaurants – Friends and Romdeng. Restaurant earnings help support the entire organization, which like MT was established to support street children.

It is great to see the two NGOs working in partnership, learning from each other.  They also have collaborated on the Child Safe program, which builds community knowledge around the need to protect.  MT implements that initiative in Sihanoukville.

MT has just expanded its own centre kitchen to allow space to begin training youth and develop food preparation skills. The next step, closer to the year’s end, will be a restaurant.

With a significant tourist population visiting the town’s many beautiful beaches and few good eating spots, the restaurant should be a success.

Other options are also being considered that, like the restaurant, might generate revenues to support MT programs and help lift the annual fundraising burden.

We are always keen to hear of any development, social enterprise models that have been tried successfully in similar contexts.

We’ve been thinking a lot recently about how most people view philanthropy. We’ve been thinking that they view charitable giving  as something intensely private, something that comes from goodwill, from the heart, something that ought not to be confused with the rest of life, with numbers, with market norms.

We’ve been thinking that many people don’t really want to focus on the tough issues, on the “why?” for philanthropy: That 3 billion people, almost half of our world’s population, lives in poverty on less than US$2.50 a day, that 1 billion people don’t have access to clean drinking water, that 24,000 children die daily from poverty.

And then beyond poverty, the environmental challenges we face from increasing temperatures and rising sea levels to disappearing forests, from dramatic declines in fish populations to loss of terrestrial biodiversity.

We’ve been thinking that maybe we genuinely don’t have time in our busy lives to focus on what’s happening in the developing world or even the next neighborhood over, or maybe we just don’t want to see for lack of solution. What can we do, after all but write that check and feel that we have done our part?

It is true, that poverty, water shortages and the myriad environmental challenges don’t yet directly impact most of our own lives, which are full enough of each day’s stress.  So when it comes to philanthropy, to volunteering, we want to just enjoy the giving.

We prefer to contribute with emotion, with friends, regardless of the cause, without looking at numbers, statistics, without necessarily thinking about the end result. We want to give to what we know, what we assume will work, what we believe has always worked. We want the safe option, to be part of a community of people doing the right thing in the comfort of friends.

Understandable when we consider that the word philanthropy, loosely translates from its Greek roots as “love for humanity.”

But the reality is there is much more good work that could be done with the US$300 billion Americans give each year – an estimated 45 percent of world philanthropy. And the reality also is that to fix the damaged world our children will inherit, the poverty of our burgeoning world population, we must offer more than just “doing good” as an answer.

We must work against the sense of cross-purposes involved in thinking about the application of market norms to things social if we are to make the real and urgently needed change.  We must pay attention to the issues to which we are giving and use our philanthropy wisely to ensure we are indeed part of the solution.

There is precedent for doing more. We can look into philanthropy’s not so distant past to see that the Rockefellers and Vanderbilts were as innovative as it came in their charitable works. And of course it was Andrew Carnegie who so famously recognized the need for smart philanthropy, warning that most charitable acts go awry.

At essence, the philanthropy sector must draw on all resources at its disposal to build codes and gather information on and publicize successful or failed practices, we must learn to harness markets more effectively, to innovate around business models that can bring the sweeping changes we so badly need. There needs to be more tolerance of risk with charitable dollars.

Of course some of this is already happening with the growth of venture philanthropy, micro-credit and social entrepreneurship, with new models of investing for social impact, but there needs to be more and faster.

How can we promote transformation, not just in the professional philanthropic sector, but also among donors, which in turn will fuel change among implementing non-profits? How can we transform the attention paid to short-term results into a more patient investing in our future?

The sex trafficking and abuse of children is a growing problem regionally fueled by the $32 billion internet porn industry. As I’ve written earlier, UNICEF estimates that every year 1.2 million children are trafficked for sex, adding to the millions more already in captivity. 

Trafficking of children is highly lucrative and while profits are high, penalties are low in most Asian countries.  Internet porn isn’t the only outlet; growing sex tourism in Asia hasn’t helped. Child victims usually come from small villages, where awareness is lowest and poverty worst. 

Southeast Asian countries are source, transit and destination countries for child-sex traffickers and pedophiles. There is clear need for better education and awareness regarding the dangers children face. 

While, there are some excellent programs for Child Protection developed by local and international groups in Asia, for budgetary reasons these usually do not include smaller villages and often even slum communities where children are most at risk. 

It is here that awareness is lowest and families are often groomed to part with their children, supposedly to good jobs in the cities.

Parents, often faced with terrible decisions around paying medical and food bills, will separate from a child thinking they will be looked after by the kindly “auntie” or “uncle” who has promised the family financial support in return.

In rural and some slum communities, families, authorities, teachers and even small NGOs are neither aware of the problem nor able to prevent it.

Stairway Foundation  recognized years ago that in the Philippines, a favorite child-sex tourism destination, the 1.5 million street children and many millions more living in urban slums were easy targets.

In response, SF has developed three purpose-made animated films on incest, pedophilia and child-trafficking that have helped hundreds of organizations warn communities there.  But the message needs to spread widely in Asia and parents need to see alternatives.

Hong Kong-based ADM Capital Foundation is helping SF develop the animation materials and accompanying training into a regional strategy under the title, Break the Silence.  We believe that not only will BTS be complimentary to child protection programs already in place, but could be used in Western countries to educate young people about internet child pornography.

Ultimately, the goal is to build an effective awareness and protection program through local organizations that are able to offer a first line of support to children at risk of trafficking and abuse.

The program is designed to grow into a sustainable initiative driven by SF in co-operation with regional partners, sharing its approach toward reaching out to and effectively protecting marginalized children across Asia.

Have you seen any particularly innovative child protection work in Asia or beyond?  We are keen to learn of others working effectively in this arena.

I recently spent some days in Bangladesh with Friendship and the excellent social enterprise’s executive director, Runa Khan. Friendship works with tens of thousands of the world’s most-vulnerable people who live in the northern Chars, remote and shifting sandbar islands that flood in winter and suffer drought in the summer.

Located about seven hours from Dhaka, these must be some of the most inhospitable habitats anywhere and consequently life expectancy for the forgotten people is only late 40s. In the rains, the islands shrink to slips of land with a few banana trees, with inhabitants and their livestock often forced to rooftops to survive the floods. In the heat of summer, the walks to the villages are often as long as three kilometers from the river through unforgiving sand.

An estimated 4 million nomadic people inhabit the 200 islands woven through the Brahmaputra river where land flattens toward the Bay of Bengal. The sand dwellers migrate from one island to another as much as 50 times in a lifetime, carrying with them their tin houses in the floods.

Climate change is clearly felt in Bangladesh’s distant northern and equally distant southern regions, where Friendship is almost alone among NGOs in working. Government reach here is also limited, Khan says. The people used to at least have certainty about the weather patterns but now the rains and droughts are harder to predict and more extreme, she says.

Friendship started its work more than ten years ago providing health care to the communities on a specially outfitted hospital barge, brought from France by Khan’s now husband, French sailor Yves Marre.  Now two hospital ships and an ambulance boat ply the Brahmauptra spending a month or two in each location, offering primary care at about US 10 cents for men, 5-7 cents for women and children as well as affordable basic surgery to the region’s weather-beaten inhabitants.

From medical care, Friendship has extended into education, (both for children and adults), livelihood and vocational support, working closely with communities to help them meet all their needs. With a staff of around 350, a complex schedule of foreign doctors and other medical professionals who fly in for specialized care, Friendship works with an estimated 40-50,000 people previously served mostly by microfinance providers, who often prayed on the extreme poverty.

Khan points out that although microfinance can work for people with at least some education and means of support, it is often not appropriate for the poorest, who will use any available funds simply to buy food for their families.    Many lenders, she says, show up on the islands with offers of cash, promising interest rates of only 10 percent annually. Without knowledge of basic arithmetic, the people take the money, spend it and then must meet the payments that often add up to rates closer to 50 percent, she says. And these are some of the better microcredit institutions. Money lenders charge as much as 120 percent.

“When we first start working with a char one of the first things we must do is unwind the microfinance loans,” Khan says. “People at that level of poverty need grants and other forms of support not loans.”

Khan says that the char people more than anything need, “hope for tomorrow” and Friendship offers education where there were no schools, healthcare where there were no doctors, livelihoods where people had none, community organization where people were disperse and disaster preparedness where there wasn’t any. A focus is on discussion, trading information, and building savings to prepare for years where the floods or droughts are life-threatening or force a relocation.

Friendship is also working to create a harmonious environment in the stark landscapes, building appropriate and local farming techniques for sand, bringing in solar where they can – with an emphasis on keeping people in their places of birth. Without Friendship, many people from these regions have swelled the slums of Dhaka in search of work.

Schools can be disassembled in three hours and moved to higher ground, girls are taught weaving and dying – skills that help them contribute to the family income and avoid an early marriage (12-14 was the norm before Friendship arrived). Community health workers are trained and sent to the villages, where they teach local people about nutrition, sanitation, about warning signs in a pregnancy and basic child health techniques. They also can dispense basic medicines.

“We listen to the communities, hear their needs and respond in ways that are appropriate,” says Khan of Friendship, which is surely one of the more innovative organizations I have seen.

Choosing how to give philanthropic dollars is usually a personal, often private, and hopefully rewarding enterprise many people like to keep close to home.

Those who spend much of their lives juggling returns on their financial investments and building wealth, often prefer to let other factors determine how to give to charity; emotion, for example, and perhaps friendship since frequently giving is something done in the comfort of circles or with friends.

The ever-bigger M'Lop Tapang centre for street children in Sihanoukville, Cambodia

But what is the significance of the donor community? Giving USA reports that every year, 40 million individual donors in the U.S. contribute $250 billion which represents more than 75% of total giving. That is a significant wad of cash that could be put to good use cleaning our environment and making our world a better place for marginalized communities. And that’s just in the U.S.

Obviously, there is no right approach to philanthropy and no absolute way to judge how effective a donation has been, despite that over the past two decades a whole industry has grown up around measuring social impact. But I think that once again we know more about what we don’t know rather than what we do.

Why do we need to think about how we give anyway? Isn’t that the point of giving – not to expect any return? I would say yes, true on one level, but not really. Why? Much has been written recently about the pitfalls of aid more generally. Two of the more vocal critics are New York University’s Bill Easterly and Dambisa Moyo whose book Dead Aid caused wide controversy.

The trouble is, without a concerted strategy or effective tools to guide us, many individual donors, grant-making bodies and foundations alike fall into the trap of providing aid that in the longer-term CAN be more damaging than helpful, despite our best intentions.

Because of issues around governance, particularly in a region like Asia where corruption is rampant, donors bypass governments, choosing instead to invest in a network of NGOs, which keeps these same NGOs flush with cash and lots of people employed.

If the NGO isn’t particularly thoughtful and doesn’t engage local government, this giving strategy also deprives the state of any stake in change and almost relieves them from the responsibility of improving the lives of marginalized citizens without a voice.

Another issue is that donors frequently prefer to contribute to contained NGO projects rather than to strengthening the organization simply because programmatic support fits with a particular donor funding agenda.

Although building new programs or expanding existing ones is important in terms of an NGO widening its impact, these often come at the expense of organizational support. It’s hard to see how an NGO can create a program, monitor it and measure its impact without sufficient organizational resources to do so.

Occasionally, or more than occasionally, an NGO has bent its needs to receive the targeted funding so there is little incentive or lack of adequate skills to really build.

And often that programmatic support is short term, given in periods of two to three years, after which the project is expected to be magically self-sustaining. Usually that is unrealistic and once funds are gone so is the program, leading to a real waste of resources.

So how do we make sure, as donors, that we are working as effectively as we can be with our own resources and not operating counterproductively, particularly in the developing world where issues are deep and broad?

This brings us right back to much talked about measuring impact. An excellent Wall Street Journal Article on Friday, Measuring the Bang of Every Donated Buck by Alice Hohler is a good discussion of the issues around this topic. http://bit.ly/d3Afil.

She points out that while many companies and NGOs have developed formulas for measuring the effectiveness of a donation, there still is no real magic box. She points to the tricky question of the unique qualities of nonprofits that are each fulfilling a social need in their own way.

There is little standardization in this field and little reason why one set of measures would fit all. Naturally, each organization then requires its own evaluation to assess its effectiveness and that is prohibitively expensive. It certainly isn’t scalable, which is another obsession among the donor community.

At the same time, any analysis of impact on the part of an NGO is only as good as the information gathered and few organizations have the resources, skill set or manpower to gather relevant data and then assess the real benefit.

An organization that  works to get children back into school will have a much easier time determining impact than for example a conservation group that works with communities to educate them about biodiversity and the value of preserving their forests.

But even in the first instance, we see there are many, many ways to count!

And then, how to compare organizations working in different spaces to determine which would use additional resources more effectively, providing the greatest benefit to a particular community?

We find that the best way around this question is to work in a holistic way with organizations, to help them set their own measurements with their particular children, to constantly work with them on developing initiatives and monitoring their effectiveness.

In that way, we can help them refine impact, reach more children or work more effectively in a particular conservation space. We shy away from the obvious numbers that are so often meaningless, preferring instead to let the work tell the story.

Any thoughts on interesting innovation in impact measurement seen working well?

The excellent Stairway Foundation, based in Mindoro, Philippines (http://bit.ly/cNDOLa) has produced three animated films directed at an Asian audience that warn children and their families against the dangers of child sex trafficking.

From the comfort of our Western-world homes, trafficking in children for sex is unthinkable. Still, every year 1.2 million are sold for sex, adding to the millions more already in captivity. These children, with an average age of 14, feed into a burgeoning child sex market with a value estimated by UNICEF at US$32 billion. The growth in this horrific industry has been fueled by the boom in child pornography via the internet. Most people don’t understand, perhaps, that logging onto a child porn site in the U.S. or Europe has terrible ramifications for children in captivity.

In the Philippines, a favorite child sex tourism destination, the 1.5 million street children and many millions more living in urban slums are easy targets. For close to 20 years, Stairway Foundation, run by Danish Lars Jorgensen and American Monica Ray, has helped 700 organizations that work with children at-risk there. Using theatre and the three purpose-made animated films on incest, pedophilia and child-trafficking, SF has touched tens of thousands of Filipino children as well as many more around Asia. The films have been translated into eight Asian languages. They are accompanied by training materials and cartoon books that educate and warn, making the messages relevant locally. A traveling theatre production written in part by abused children carries a similar, difficult message.

The most recent film, Red Leaves Falling, is a 22-minute animated film that traces the story of two sisters, eight and 14, who are sold by their desperate mother to pay medical bills for a sick brother. The mother believes the children will be working as housemaids but instead they are trafficked to pornographers and a brothel. The story is desperately sad but reflects a reality of poverty and desperation faced by many in Asia and elsewhere. The message is clearly that we all need to speak against this unimaginable cruelty that exists because of the complicity inherent in silence.  http://bit.ly/bKrAv2

Despite the excellent materials and the need for these to be seen, most of the films and accompanying training materials have not had the breadth of distribution they deserve. There is urgent need to widen the net, particularly of the rural poor exposed to the materials SF produces. Cambodia and Thailand, for example, are other source, transit and destination countries for child sex traffickers and pedophiles  where there is clear need for education and awareness regarding the dangers children face.

There, excellent programs for Child Protection have been developed by local organizations such as M’Lop Tapang, Friends International (Child safe program) as well as some of the better known international groups. These organizations and others, however, do not have the breadth or funding to take awareness and training programs to smaller towns and villages where children are most at risk of abuse.  Consequently, in these communities, families, authorities, teachers and even small NGOs are neither aware of the problem nor able to prevent it.

At the same time, organizations like SF need to build sustainability into what they do. The films, valuable tools, are expensive to produce. ADM Capital Foundation is working with SF to develop a model that would allow for wider distribution and training and generate income, essentially selling to NGOs what has previously been offered as free product and services. The idea is for funders to pay for needed and experienced training. Any thoughts regarding this or similar models would be helpful!