USAID/EAST AFRICA/FFP MONITORING MISSION OF

UNCLAS SECTION 01 OF 04 NAIROBI 001496 SIPDIS USAID/DCHA/AA FOR WGARVELINK, LROGERS DCHA/OFDA FOR GGOTTLIEB, CGOTTSCHALK, KCHANNELL DCHA/FFP FOR JDWORKEN, TANDERSON, TMCRAE, WHAMMINK AFR/EA FOR JBORNS, SMCCLURE ROME FOR FODAG GENEVA FOR NKYLOH BRUSSELS FOR PLERNER NAIROBI FOR JMYER; ADWYER KIGALI FOR KMULLALLY, CTOCCO, RWASHBURN, VSAFALI NSC FOR JMELINE SIPDIS E.O. 12958: N/A TAGS: USAID SUBJECT: USAID/EAST AFRICA/FFP MONITORING MISSION OF TITLE II COOPERATING SPONSORS IN RWANDA ¶1. SUMMARY: Regional East Africa FFP Officer and USAID Rwanda Mission conducted a joint monitoring mission February 26 ? March 3, 2007, of Title II Cooperating Sponsors (CSs) World Vision (WV),Catholic Relief Services (CRS),ACDI/VOCA and their sub-grantees: Africare, ADRA and Food for the Hungry International (FHI). They operate under Development Assistance Programs (DAPs) that are all scheduled to end between 2009 and 2010. Program implementation by the CSs has been severely hampered by budget cuts, delays in call forward (CF) for monetized and distributed commodities and the various clarifications on food aid requested by the Rwandan Government. Despite the challenges, the CSs continue to provide good and important assistance to vulnerable populations in Rwanda. END SUMMARY ¶2. The CSs are providing support to vulnerable populations including People Living with HIV and AIDS (PLWHA),elderly people, orphans, street children in safety net centers, farmers using improved agriculture techniques in food insecure zones and agri-business cooperatives. These groups are supported through direct distributions of Title II commodities as well as proceeds from the sale of monetized commodities that are distributed as grants. BUDGET CUTS, LIMITED CALL FORWARD AND DELAYED PROGRAM IMPLEMENTATION ¶3. The Title II non ? emergency program in Rwanda was valued at USD 13.3 million for FY 07. However, under the new F Process, that sum has been reduced to USD 11.4 million and this will be the working figure for the remainder of FY 07. The newly announced budget reductions will surely force CSs to reduce staff and cut down on critical activities even more. In addition to the budget cuts, the Cooperating Sponsors were all faced with the inability to call forward commodities for monetization and distribution in a planned or timely manner. Additionally, the Mission in Rwanda and its partners were challenged for a period of time, by the Government of Rwanda?s restrictions on food aid. This situation has been worked out to the satisfaction of all parties. These instances have prevented partners from fully implementing the DAPs as approved. ¶4. The implications of these measures have been far reaching for the CSs and their sub-grantees. Program implementation has been severely hampered. CRS? Comprehensive Close-Out Strategy Amendment (COSA) with implementation 2006-2009, has two objectives: direct distribution to 39 Safety Net Centers and food security initiatives. They are half way through their program in the first year and they have yet to start implementing the food security initiatives that represent 75 percent of their programming. ACDI/VOCA?s approved five year DAP (2005-2010) allocates USD 3.2 million for distribution as grants to local cooperatives. As of FY 07, they have only disbursed USD 50,000 at this half-way point. Similarly, WV was to receive USD 5 million to disburse as small grants. As of FY 07, more than half way through the DAP, they report receiving USD 1.3 million. The challenge for the TITLE II grant dispersal process is that grants ideally should not be distributed in the last year of the program because follow-up will be difficult during the close-out period. Given program delays, it looks as though CSs will have to do just that. ¶5. WV and Africare (a sub-grantee of ACDI/VOCA) have not received any CF commodities in FY 07. There is a consignment due in March/April. For now, they are working off their FY 06 balance, but will run out of cash in March. Africare?s distribution commodities have been insufficient, forcing them to diminish rations to their target population of PLWHA. Currently they receive NAIROBI 00001496 002 OF 004 12.5 kgs of Corn Soya Blend (CSB) and one liter of oil instead of the 25 kgs CSB, 1.8 liters of oil, and 25 kgs of Soya-Fortified (SF) Bulgur per family per month, suggested by USAID. In many instances, these food rations are the only lifeline for PLWHA who need food to properly digest Anti-Retrovirals (ARVs) as part of their AIDS management therapy. ¶6. The cash that comes from 202e grants and monetization are needed early in the fiscal year in order to move programming along. It is understood that a large part of the reason for CF delays is caused by the continuing resolution. FFP has had to prioritize available cash resources for the immediate emergencies. The delays of CFs have forced the CSs to reduce staff and/or slow down activities resulting in low morale of their teams. Further, the CSs have to also work hard to maintain the morale of their target beneficiaries. ¶7. FFP/W, in an effort to correct the CF delays, has initiated ways to better plan and prioritize non- emergency spending. They have developed a pipeline analysis tool that CSs have been requested to test. This will facilitate FFP/W in knowing the ?what, when and whys? of programs needs in order to more effectively lobby for necessary resources for Multi Year Assistance Programs (MYAPs) in a more timely fashion. The fine- tuning of this process will allow for greater predictability of non-emergency needs, as well as promote a greater integration with other resources. FFP/W reports that they have now prioritized the CFs and cash for the DAP partners in Rwanda. Final confirmation is expected in April 2007. These changes in Washington to improve the planning and operations of food aid programs are welcomed in Rwanda and the Mission looks forward to implementation. TITLE II and the SUPPORT FOR PLWHA ¶8. In Rwanda, TITLE II resources are feeding 17,445 PLWHIVAs through the two Development Assistant Programs of WV and ACDI/VOCA and their sub grantees FHI, ADRA and Africare. The USAID team was joined by PEPFAR on visits to two associations of PLWHA: Imbaraga z?Urukundo (Power of Love) and Inziramugayo (People of Integrity). In order to be a member of the associations, one must be HIV positive. There were hungry people (with very low Body Mass Index (BMIs)) that were turned away if they were not HIV positive. The Imbaraga z?Urukundo Association is located in Nyamata District in the Eastern province. They are one of 135 associations supported by Title II through World Vision and ADRA. There are 111 members in which 71 are receiving food due to their ARV intake. WV is employing PEPFAR guidance to scientifically target food aid beneficiaries which is primarily based on a recipient?s BMI. In addition to food, WV provides nutritional training and counseling. The USAID/PEPFAR team listened to many testimonies by association members supported by Title II. They shared with enthusiasm how the food enabled them to intake the ARVs that usually caused vomiting and nausea. ?Medicine without food is not good? declared one member. They spoke of their weight gain and new-found energy. A widow with five children shared that because of the food she was getting along with the ARVs, ?I now have strength to work in my garden?. Another member declared that her CD4 count (that determines the level of immunity against opportunistic infections) went from 23 ? 249 once she started taking food with her ARVs. ¶9. Africare supports 34 Associations numbering 1,210 PLWHA in Nyamagabe district in the Southern Province. Through a series of volunteers they provide Home Base Care, peer education and testing and counseling and pay NAIROBI 00001496 003 OF 004 health fees. Africare provided community-based nutritional support for 5,013 moderately malnourished children as of February 2007. ¶10. The GOR has established a protocol that requires that direct distribution recipients be ?graduated? from programs after six months. All of the CSs providing direct distribution in the form of safety nets find it difficult to respect this protocol. World Vision graduates beneficiaries once they improve their nutritional status as measured by BMI, which does not usually respect a six-month calendar. Similarly with Africare, they are feeding 12,600 beneficiaries. They find it difficult to respect the six month rule as they operate in an acute food insecure zone where one can find an entire family that is HIV positive. Pascasie ? 13 Years old, HIV+, with Help and Hope ¶11. The PEPFAR/USAID team met Pascasie, a 13 year old girl diagnosed with HIV when she was just 2 years old. She has lived with her grandmother and aunts since that time when she lost both her parents to AIDS. She is twice the age of her 2nd year primary school classmates, but opportunistic diseases such as tuberculosis have forced her to miss many days and months of school. Pascasie appears healthy and when asked, how she feels, she responds ?Meze neza? in Kinyarwanda which means ?I am well?. She is understandably shy with all eyes on her, but she readily receives the hugs we want to give her. Her 75 year old grandmother and her two aunts are all widows. They farm a small plot of beans in very sandy soil that ?doesn?t give much?. They depend on the one month ration distributed by Africare that in reality, only lasts 15 days. Pascasie is visited by Africare?s Home Base Care (HBC) volunteer Godbert Umwana who visits 18 households per month. She moves with her HBC kit filled with petroleum jelly, compresses, thermometers, tarp, wound dressing material and gloves and an apron, that all fit in a back pack that easily weighs 22 pounds. She does all of this on foot with her furthest client located some 12 kms away, in return for a monthly ration of 6 kgs of CSB and half tin of oil. When asked why she does it, she responds, ?I worked as a health professional in the hospital and when Africare made the requests for volunteers, I thought I would be good at it.? She is particularly challenged in the rainy season with all the walking that is necessary, but she still trudges on for her clients who anxiously wait for her to treat their wounds, bring news of the day, see her beautiful smile and just talk and keep them company... PEPFAR AND THE POSSIBILITIES ¶12. Though the CSs are doing good work with associations that support PLWHA, food aid alone it is not sufficient. One way to graduate members out of the safety net programs is to support them in income generating activities. CRS reports using USD 100,000/year of its own resources to provide start-up resources for income generating activities such as the provision of cows for milk and cheese production and start-up equipment support for commercial activities. ¶13. Rwanda is one of four PEPFAR countries in Africa that has TITLE II. In a time when many budgets are shrinking, the PEPFAR budget is increasing annually by 30 percent in Rwanda. It is an opportunity to fill the many gaps that exist with TITLE II partners supporting PLWHAs. The Mission and USAID/FFP are challenged by the most appropriate mechanism for PEPFAR to finance TITLE II partners. Having two separate contract actions is a very cumbersome way to do business when the mission is NAIROBI 00001496 004 OF 004 doing its best to foster program integration. OTHER PARTNER FIELD VISITS ¶14. The USAID team also visited WV?s agro forestry initiatives in the Eastern Province. Title II was used as Food for Work to create progressive terraces and tree plantation as an anti-erosive measure. The teams initially planted 30,000 trees, but due to drought, only 5 percent survived. Another 5000 trees were planted with an improved survival rate of 80 percent due to the good rains. Local farmer Cassian Rutagana received a 3 month ration for his labor in making terraces. When asked what difference terracing made, he responded, ?My yields are three times more than before. If I had not used this technique, my seeds would have been washed away to the marshland?. As the team prepared to depart, Cassian approached our vehicle and leaned inside, and through an interpreter said, ?Please thank the American people for us?. ¶15. The USAID team visited a series of safety net centers: Maison de la Jeunesse, based in Kigali and supported by CRS, provides meals and vocational and educational training for street children. CRS provides food aid to the Noel Orphanage of Nyundo in Rubavu District in the Western Province, who in turn provides food and shelter to over 600 orphans between the ages of a few weeks to 19 years old. The USAID team visited agribusiness cooperatives specializing in coffee, wheat flour and cheese, supported through grants, buyers of monetized commodities or leveraged loans through ACDI/VOCA. ¶16. The USAID team spent a morning touring the coffee washing station of COOPAC in Nyamwenda sector of Rubavu District of the Western Province, on the shores of Lake Kivu. The Cooperative was established in 2001 with the aim to regenerate the coffee sector in Gisenyi region given its high potential for high quality coffee production for a gourmet market while increasing the welfare of coffee producers. They received Fair Trade certification in 2003. COOPAC has been a long time partner of ACDI/VOCA who supported the construction of the coffee washing station under the previous DAP. Currently they work on capacity building with the cooperative management. The investment has paid off as COOPAC won Third Place overall and First Place among Rwandan coffees at the 2007 Taste of Harvest Coffee Cupping Competition in Addis Ababa in February 2007, sponsored by the East African Fine Coffees Association. This was a stellar achievement for COOPAC and helps to boost the reputation of Rwanda coffee internationally. CONCLUSION ¶17. Despite the multiple challenges for the FFP Cooperating Sponsors in Rwanda, they are doing impressive activities with vulnerable populations. In HIV/AIDS programming there are clear opportunities for PEPFAR to twin with FFP Cooperating Sponsors to fill the clear and pervasive gaps in sustainable support for PLWHAs. FFP/Washington is making efforts to address the issues of delayed call forward. The CS? were advised to continue to document their progress (or lack thereof) and respect reporting deadlines in order to maintain the institutional memory of why indicators and objectives have not been achieved as the case may be. USAID/East Africa/FFP would like to extend kudos to USAID/Rwanda SO7 team who continue to provide active monitoring and guidance to FFP partners in Rwanda. RANNEBERGER