Program Manager

Marie Ann Fernandez is the Program Manager for ADRA in Hais.

In Yemen as in other developing societies, poverty and disability are closely linked in a vicious cycle that is difficult to break. Apart from social and cultural issues surrounding disability, social barriers like gender create an exclusion from community life and contribute to the impoverishment.

The project here in Hais is focused on the physically challenged and apart from health care we look at strategies to integrate the disabled into the community and create an environment for the process of change of social habits and economic opportunities. Education and training are keys to assisting disabled people to become economically independent and active members in society.

There are about 2,000 disabled in the Hais area and one third of the disabled are landmine survivors, a result of the civil war in the 1990’s. The remaining two thirds have disabilities related to other causes such as accidents, unskilled deliveries, medical mistakes, poor maternal health related to malnutrition and hereditary issues. The number of the disabled people including children has constantly been increasing over the last 3 years. In 2005 several new cases of cleft lips and club feet have been reported to our office. Birth related disabilities and eye diseases (Glaucoma) continue to be a main issue.

The households in the project areas are mostly headed by women. Illiteracy rate in the Hais area is 75% and there are no vocational training opportunities. Due to the cultural barrier that forbids girls to be taught by male teachers, women face a lack of education for further studies. Therefore, women in general are more or less bound to their villages and depend on the establishment of a local institution in order to develop their skills and talents. Currently most of the women from villages in the project region do not pursue any income generating activity due to lack of financial resources.

The current program commenced in July 2006 and was expected to benefit 525 people directly and 3,150 indirectly. However the needs have grown, such that we now service a direct beneficiary of 1,353 people directly almost 3 times the expected target. It is difficult and indeed impossible to turn away people in need.

Responding to these needs of the disabled there are 5 current priorities in Hais:-

• 
  
  
  Access to health care



• Alternative treatments such as Aqua Balancing



• Vocational Training



• Small Enterprise Development



• Awareness raising about basic health care and cleanliness issues
  
  Health Care
  The overwhelming majority of the disabled, especially women, remain without services, particularly in rural areas. A certain proportion are able to attend the Adra Hais clinic located within our building and are able to take advantage of physiotherapy and consultation conducted by our female physiotherapist. This is a service not provided elsewhere in the community.
  
  A large number of disabled are housebound and for these we provide home care services performed by our community based rehabilitation workers (CBR). The CBRs travel throughout the Hais region using our rented vehicle. They develop an individual treatment plan, define the steps and indicators for an improvement of the health condition and perform the treatment. Furthermore, they train family members to deal with their disabled and raise awareness in the community about the causes, care and prevention of disabilities.
  
  Some disabled have serious issues to resolve such as cleft palate, club foot and glaucoma and are referred to appropriate institutions in the capital, Sana’a, as well as other larger centres Taiz, Aden and Hodeidah for treatment. ADRA both transports the patients to hospital and pays for the hospital treatment.
  
  The deaf and mute in the community are a significant proportion and thus sign language is required in order to integrate these people, both adult and children into their families and communities. One of our team has now been trained in sign language and is responsible for this program.
  
  Alternative Treatments
  Aqua balancing is a treatment whereby immersing the patient in water, muscle tension is released increasing the mobility of the joints and stimulating the coordination of the nervous system. We have also found this to be an excellent way to deal with pain. Importantly the treatment cost merely requires transport and two trained CBR workers. Secondary benefits are a recreation and the time allows for health education. The therapy is carried out in the coastal region of Khokha about 30 kms to the east
  
  
  Vocational Training
  Vocational training in the Hais area is absent and thus this facility at ADRA plays a key role as a basis for future employment and income for the disabled. At the ADRA office in Hais we offer vocational training carried out by specialist trainers teaching skills in embroidery, knitting, weaving and tailoring. Due to social restrictions, women from the Hais rural areas are not able to travel and thus we send trainers to the local villages. This involves a higher cost of transport but this is a popular program.
  
  Micro-Finance
  Small Enterprise Development
  
  In order to extend the vocational training into a greater likelihood of economic independence and self-sufficiency the ADRA program offers small capital sums for the disabled, their families or dependants as well as poor individuals. Currently there are no credit opportunities for this part of the community. The amount of loans given ranges from $50 to $150 and requires the borrower to be approved with a business plan. Loans are for 8 months during which the loan is repaid on a weekly basis woth interest at a modest rate of 1%. The project also involves the community and ADRA team to explore marketing opportunities with other sectors, e.g. hospitals, schools, merchants, shopkeepers in Hais, Khokha and other surrounding cities.
  
  
  Awareness raising and health education
  
  As the movement of women in the Hais area is very restricted, the project staff travel to community centers in the most populated villages. ADRA CBR workers provide information about health issues and organize discussions about social behaviour towards disabled persons. The community centers serve as places for networking, training centers, social interaction between disabled families and community leaders. Through workshop facility discussion regarding the rights of the disabled, relation ship between family and disability, etc is held for health workers, community midwives, community leaders, sheikhs, local non-governmental partners, local government, teachers and disabled families. The goal is to improve the health status of the disabled and to integrate as far as possible the disabled and poor back into productive life in their communities and also create a change of family and community attitudes toward them.
  
  
  
  ADRA team in Hais
  
  The ADRA team in Hais is staffed with “volunteers” who are paid a small allowance and are trained in specific duties. They have described their responsibilities and some of their background in separate blog entries.
  
  · Hassan Moh’d is the Financial Assistant and Human Resources Assistant
  · Abdulai Yassin is the Project Co-ordinator.
  · Rita Moh`d is the physiotherapist
  · Dina Ismail is the vocational training co-ordinator
  · Fayzia Khalil is a Community Based Rehabilitation worker and she also handles the small enterprise development function.
  · Hussein Hassan is a vocational trainer for weaving classes
  · Bakil Hashem is a sign language instructor
  · Fatima Kearem is a Community Based Rehabilitation worker who assists Rita with the physiotherapy in the field and she assists Abdulai in referral activity.
  

Challenges
The main challenge to this program is that there are many more disabled people than we can handle within the framework of our program. Nonetheless we continue as much as is possible. The challenges are described as follows:-

• The limited training of the ADRA team in Hais is an issue to resolve. Team members need to attend workshops and additional training. We need to find the time to permit this activity.



• As the reader will see from Rita’s blog the physiotherapy equipment is overused and has fallen into disrepair requiring replacement.



• All of the ADRA team in Hais are volunteers who are devoted to and enjoy their assignments but we are not able to match their skill and devotion with an adequate salary. This is a serious challenge and difficult to overcome since we have to maintain a high quality.



• Our rented transport is a source of frustration since availability is unpredictable leading to delays in service delivery.



• The clinic space in Hais is insufficient to meet the needs. We operated with only one bed for each of male and female patients plus a small room for exercise equipment. The sewing instruction room is restricted in size and is difficult to accommodate the heavy demand.



• The program has encountered the absence of a Program Manager for an extensive period leading to implementation problems. The isolated location makes it difficult to attract competent international Program Managers.

The reader can appreciate that the core of the challenge is a lack of sufficient funding. In Hais the ADRA team is thankful for the funds available for the disabled program and we hope that through God (Allah) we will find a way forward.

Religeon
The predominant religion in the Hais area and throughout Yemen is a conservative form of Islam and many are devout. Although ADRA is a Christian based organization with high respect of the people we serve in Hais, we are very careful not to use the basis of the donor funds to influence local beliefs.

Management
Marie Ann Fernandez manages the ADRA Hais office and as Program Manager, she manages the entire program of activities in the Hais Region. Marie Ann comes from the Philippines where she was trained as a social worker graduating from a 4 year College program. She has 20 years of experience working for non-government organizations (NGO) in various capacities. At International NGO Virlanie and at ERDA she assisted high risk street children in Manila as well as acting as case worker for a Vietnamese refugee camp. Monitoring and evaluating NGO programs is part of her work experience. In Sierra Leone, Marie Anne worked for more than 2 years as program management advisor for local organizations funded by Diana Memorial Fund. Her work in Sierra Leone dealt with advocacy for people with disabilities as well as livelihoods.

Marie Anne came to ADRA Hais in June 2008 and is committed through to July 2009 although she may consider extending. Her job is to supervise and give direction to the ADRA team in Hais including a broad range of activities including the mobilization and monitoring of program resources, building the capacity of staff to train for activities such as physiotherapy, skills vocational training, sign language etc. Marie Ann is responsible for the full reporting activities in Hais to the Program Director Angelica Krut and to The Country Director Nagi Khalil. She represents ADRA to other NGOs and Partners in the Community and is also part of the Administrative Committee for ADRA Yemen.