In 2020, Charles Usie, Country Director at Christian Aid UK, took part in Humentum’s OpEx Africa Online plenary: Real-Time Lessons About Resiliency and Crisis Preparedness. This panel focused on the lessons learned since the start of the pandemic and forward to lessons learned about strengthening capacity to respond to future large-scale crises. Join Charles as he discusses Christian Aid’s COVID-19 response via the Nigeria Country Programme, and the future vision.
Imagine this. You are a parent faced with a life decision to spend your only money or monthly cash hand-out to buy food for your four starving children or medicine for one child who is about to die from a preventable and easily treatable malaria attack. Which would you choose? Our experience working in parts of Nigeria suggests that many disadvantaged women in rural communities in Nigeria struggle to keep their children alive simply because they cannot afford healthcare when their child is sick. At Christian Aid, we believe nobody should face this impossible dilemma.
Leading Christian Aid UK’s work, through the Nigeria Country Programme, we have encountered these scenarios in some of the poorest and conflict-prone locations in Nigeria. According to the 2020 Humanitarian Response Plan, “The operational environment in some states in North East Nigeria, is characterised by rising insecurity, driving waves of new displacements, deepening food insecurity and malnutrition, widespread protection concerns and rights violations, a constricted humanitarian space and reduced access that hampered effective delivery of humanitarian assistance. The same reports stated that in 2019 the situation was further worsened by devastating seasonal flooding, which constrained access to affected populations, contributed to deteriorating living conditions in congested IDP (Internally Displaced Person) camps and informal settlements, and increased people’s vulnerability to disease outbreaks.
In 2019 alone, Christian Aid provided monthly life-saving food rations to 35,900 people (male -18,429 and Female – 17,471) consistently over 12 months in five selected local government areas of Borno State, North-East Nigeria. Needs assessments conducted in these locations revealed a high prevalence of severe to acute malnutrition among children and women, especially lactating women. With support from partners, Christian Aid introduced a Blanket Supplementary Feeding Programme to tackle these cases of malnutrition. By the end of 2019, 16,771 children (7,722 boys and 9,049 girls) were supported with nutrition supplements, while 13,109 pregnant and lactating women received a monthly ration of supplementary food to provide the extra nutrients they depend on.
The need to make food rations in-kind available for households displaced by conflict or disasters is well established. Most times, households are enclosed in makeshift camps or host communities, typically with no more than 100-200 meters perimeter radius. Sometimes, local markets are still active in the communities hosting displaced persons, thus establishing the need to monetize food rations and provide cash transfers for the households. For thousands of families Christian Aid has supported so far, this monthly cash-transfer disbursement is the sole income for households with an average size of five persons.
In another challenging experience for Christian Aid, a single mother of four children, who lost her husband to killer herdsmen in parts of Benue State in North Central Nigeria, explained an unthinkable decision she had to make. She could either use her monthly cash wallet provided by Christian Aid to purchase food for her family or use most of the money for malaria medicine and transportation to and from the local health clinic, which is over an hour away on a motorbike. She decided to buy food in a bid to keep everyone alive, taking the gamble to use traditional herbs to cure the sick child. Tragically, her child with Malaria died of the disease.
Nobody deserves to face such decisions, particularly those in conflict and humanitarian settings where every-day living is a far-off dream. Parents, particularly single mothers who have lost their husbands to conflict, are already struggling due to internal displacement. On top of that, they are dependent on food rations or cash-transfers for daily subsistence. A lack of affordable, accessible healthcare is a triple tragedy that compounds most women’s living experiences and must be addressed.
Learning from this experience, at the onset of COVID-19, Christian Aid recognized the existing tragedy for thousands of women and chose to act differently. With support from our donors, we designed and launched a COVID-19 response that provides unconditional cash transfers directly in the hands of heads of households (over 60% are women). In addition, we increased access to clean water for communities and households, supported health centres and workers with much needed Personal Protective Equipment (PPEs), and provided non-food items for household hygiene and sanitation needs (which includes specific dignity kits for women during their menstrual cycle, and lactating mothers).
The fundamental strategy here is providing these in-services as a monthly all-inclusive intervention within the same communities, targeting selected households over at least six months. An intervention of this nature can respond to the multiple layers of stress faced, especially women-headed families, ensuring that mothers are not forced to choose between food and medicine for their children in an already difficult conflict-prone and low-resource setting.
Targeting most disadvantaged communities alongside communities hosting displaced people, the Christian Aid C19 NAPLER DFID-funded project provided monthly cash envelops directly to 2418 households (with an average of five persons per household) in three selected States in Nigeria over the last six months. In addition to the cash transfers, this same set of households received consistent messaging on behavior and practices that could protect them from COVID-19 and what to do if infected. Although a post-project evaluation and possible impact is still being planned, the initial reaction, particularly from female-headed households, reveals a significant immediate relief to the daily challenge of survival in coping with multiple layers of suffering.
Working through COVID-19 in Nigeria, it became apparent that we must adopt new protocols or modify existing ones in the race against poverty. The establishment of the Beneficiary Selection Committee from target communities, especially involving vulnerable community members, was an effective way to access the most marginalized people in these communities. These people have the most recent information and understanding of their context, which has proved helpful. As a result, we were able to select the most impoverished people to prioritize for the project.
Digital solutions to rapidly respond in challenging low-income settings, as witnessed with COVID-19, were vital in delivering a successful project. Given the pandemic-related restrictions, digital played a crucial role in the swift delivery of assistance, communication messages, remote data collection, and a complaints mechanism. Furthermore, conflict sensitivity and risk management also contributed to the success achieved. Without an in-depth conflict sensitivity programming approach with a major focus on risk management, there is a serious risk to Rapid Response Facility (RRF) interventions, partners, and staff on the ground. Christian Aid introduced this approach to mitigate this risk by working via local partners, and with active engagement from the local community and religious leaders. Amongst other salient approaches, these learnings will remain fundamental as we continue to work in challenging, hard to reach areas where millions of poverty-stricken people live.