VZCZCXYZ0008
RR RUEHWEB

DE RUEHKM #0526/01 1420823
ZNR UUUUU ZZH
R 220823Z MAY 09
FM AMEMBASSY KAMPALA
TO RUEHC/SECSTATE WASHDC 1435
INFO RUCNDT/USMISSION USUN NEW YORK 0111
RUEHRO/AMEMBASSY ROME 0598
RUEHGV/USMISSION GENEVA 1043
RHEHNSC/NSC WASHDC
RHMFIUU/CJTF HOA
RHMFIUU/CDR USCENTCOM MACDILL AFB FL
RUEHBS/AMEMBASSY BRUSSELS 0282

UNCLAS KAMPALA 000526 
 
AIDAC 
 
SENSITIVE 
SIPDIS 
 
USAID/DCHA 
DCHA/OFDA FOR ACONVERY, KCHANNELL, KDISSELKOEN 
DCHA/FFP FOR JBORNS, JDWORKEN 
AFR/EA FOR KDEGRANGES 
STATE FOR AF/E 
USUN FOR DMERCADO 
BRUSSELS FOR PBROWN 
GENEVA FOR NKYLOH 
USMISSION UN ROME FOR HSPANOS 
 
E.O. 12958: N/A 
TAGS: EAIDPHUMPRELUG
SUBJECT: USAID/OFDA MONITORING VISIT TO NORTHERN UGANDA 
 
- - - - 
SUMMARY 
- - - - 
 
¶1. From March 30 to 31, 2009 a USAID team visited OFDA NGO 
activities in northern Uganda.  These activities focus on 
improving returning IDP's access to water, sanitation, 
hygiene and livelihoods through rehabilitation of water 
points, hygiene education, and income generating 
activities. 
 
¶2. The program is having a generally positive impact; 
however, the hygiene promotion programs continue to 
struggle as NGOs work to bring about behavior change.  This 
is evidenced by the low priority returnees give to latrine 
construction and the increase in Hepatitis E virus (HEV), 
particularly in Kitgum District. 
 
¶3. One issue noted throughout the visit was the dependency 
on foreign assistance.  It is understandable considering 
that many people have relied on humanitarian assistance for 
up to 20 years, but it does create a challenge for NGOs 
transitioning from emergency to development assistance. 
End summary. 
 
- - - - - - 
Background 
- - - - - - 
 
¶4. From March 30 to 31, USAID/OFDA Disaster Operations 
Specialist Michelle Shirley and USAID/Kampala Program 
Management Specialist (PMS) David Mutazindwa traveled to 
Gulu, Pader and Kitgum Districts to monitor OFDA programs 
implemented by the International Rescue Committee (IRC), 
AVSI, Mercy Corps, and Medair. 
 
¶5. Since 1986, protracted conflict between the LordQs 
Resistance Army (LRA) and the Government of Uganda (GOU) 
has led to a complex emergency in northern Uganda marked by 
violent attacks against civilians, extensive displacement, 
and the abduction of children for forced conscription, 
labor, and sexual servitude. In early 2005, the U.N. Office 
for the Coordination of Humanitarian Affairs (OCHA) 
reported that LRA attacks had displaced nearly 95 percent 
of the ethnic Acholi population in Gulu, Kitgum, Pader, and 
Lira districts. At the height of the conflict, 
approximately 1.8 million people were internally displaced 
by ongoing violence in Uganda. Since 2006, improved 
security, increased freedom of movement, and significant 
progress toward a negotiated settlement to the conflict 
have facilitated internally displaced persons (IDPs) to 
relocate closer or return to villages of origin. As of 
September 2008, OCHA reported that more than two thirds of 
IDPs residing in camps in northern Uganda had returned to 
areas of origin. Furthermore, security throughout the 
region is good and contributing to continued confidence in 
return. 
 
- - - - - - - - - - - - 
Hepatitis E Virus (HEV) 
- - - - - - - - - - - - 
 
¶6. On March 30, the team visited soon to terminate 
water/sanitation/hygiene (WASH) activities in Kitgum being 
implemented by IRC and AVSI.  The NGOs are constructing 
and/or rehabilitating boreholes, hand-dug wells and 
latrines, and undertaking hygiene education and promotion. 
 
¶7. Both organizations cited poor sanitation practices as 
the leading causes of diarrheal diseases, particularly 
HEV.  Because of the HEV outbreak in mid-2008, IRC has 
invested significant effort in prevention and treatment of 
the disease in Kitgum.  The team visited Adyel village, 
where IRC is working with a community health group, village 
health teams, and water user committees to raise awareness 
of HEV.  The community health group performed a play that 
outlined the causes of HEV, the importance of seeking 
medical assistance, and measures that can be taken to 
prevent the spread of HEV. 
 
¶8. Following the IRC visit, the team met with AVSI and 
reviewed its WASH activities in Otto Jamaica village where 
roughly 55 IDP families have returned.  AVSI installed a 
borehole after learning that residents were using a 
contaminated hand dug well.  Following the installation of 
the borehole, village residents were provided with 
instructions, tools and prefabricated floor slabs to 
construct household latrines. 
 
¶9. AVSI highlighted increasing HEV cases as the biggest 
issue it deals with at the moment.  Given the continuous 
return of IDPs, it is often hard to pinpoint where the 
disease began thus making it difficult to determine where 
to target interventions.  There is also a growing concern 
that the number of cases could rise significantly with the 
onset of the rainy season.  In addition to the challenge of 
behavior change, AVSI said latrines are non existent or 
poorly maintained in IDP transit sites and home villages. 
Furthermore, as returns increased, NGOs turned their focus 
from the original IDP camps to transit sites and home 
villages.  The maintenance of latrines in the original 
camps was thereby reduced.  Unfortunately, people continue 
to move between the original camps to transit or home 
villages, carrying HEV with them. 
 
- - - - - - - - - - - - - 
Returnee Support in Pader 
- - - - - - - - - - - - - 
 
¶10. The team visited Mercy Corps activities in Wol sub- 
county in Pader District.  Mercy Corps has activities to 
support the economy and market systems, WASH, and 
agriculture and food security.  As part of the former, 
Mercy Corps is implementing a labor based road project to 
shorten travel times from Okwadoko village and surrounding 
areas to Pader town.  The road was identified as a priority 
by district government officials and returnees.  Each 
worker is given an assignment and is paid based on the 
completion of that assignment.  This allows beneficiaries 
the flexibility to work on the project and prepare their 
fields. 
 
¶11. From Okwadoko, the team moved to Otingo-wiye to see 
WASH activities being implemented at a local primary school 
and agriculture activities.  Mercy Corps constructed school 
latrines and is promoting child-to-child hygiene education 
in the schools.  Agriculture activities are focusing on 
produce marketing.  This was based on input from 
beneficiaries, who stated that they didnQt need seeds and 
tools, but required assistance in selling the produce. 
Since all of these activities were designed based on input 
by the local communities, there is a strong sense that they 
will be sustainable especially since there appears to be a 
sense of ownership of many of the activities. 
 
¶12. The last site visit was with Medair.  The team met with 
the hygiene coordinator, field director, and health 
coordinator.  Medair is implementing WASH activities in 
Pader District.  The health coordinator was very 
knowledgeable about the Medair program and was able to 
confirm the positive impact of the OFDA-funded WASH 
interventions on the general health status of the 
population. 
 
¶13. However, despite the program's initially evident 
impact, this was the most disappointing visit of the two 
days.  While Medair's OFDA-funded activity ended on the day 
of our visit, there was unfinished work in the sites 
visited.  The construction of the school latrines visited 
was completed a month before, however, the latrines are not 
being used because the holes in the floor have not been 
cut.  When asked, Medair blamed the contractor.  When a 
school teacher was asked about latrine use by the students, 
he stated that boys use two rudimentary structures, while 
girls used brush around the school.  It was clear that 
Medair had not visited this village in quite some time. 
The Program Management Specialist will return to the 
village in the coming months to ensure that the work has 
been completed. 
 
- - - - - - 
Conclusions 
- - - - - - 
 
¶14. Overall, USAID/OFDA funding has made a significant 
impact on the lives and livelihoods of the returning 
population.  As with any intervention, there are challenges 
with program implementation.  Therefore, it is suggested 
that follow-up visits be made by the Program Management 
Specialist over the next year to ensure that activities are 
being carried out and completed per the grant agreements. 
 
¶15. There was little or no branding and marking of 
USAID/OFDA-funded activities, with the exception of t- 
shirts and caps.  When questioned, the NGOs stated that 
signs will be posted at each site in the coming weeks. 
This is another issue that should be followed up on during 
subsequent monitoring visits, especially since each NGO 
received funding for branding and marking activities. 
 
¶16. Finally, with the approaching rainy season, USAID will 
need to continue to monitor HEV.  The increase during the 
dry season is disturbing and if the trend continues, there 
could be a spike during rains in the May-July timeframe. 
 
HOOVER