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May 22, 2008

Myanmar: PSI's Response to the Cyclone Crisis


Rice distribution in Rangoon.
Associated Press

After an exhausting week dealing with (and living through) Cyclone Nargis and meeting with Washington, D.C., decision makers, John Hetherington, Myanmar's country representative for Population Services International, sat down with Conde Nast Traveler's Julia Bainbridge to tell her what the situation in Myanmar is like now, how PSI plans to address problems there, and how you can help.

Conde Nast Traveler launched the Five & Alive Fund with Population Services International.

CNT: Have you been on the ground in Myanmar since the cyclone? Could you briefly describe what the situation was like there?

JH: I was in Yangun with my family during the cyclone, which was pretty intense--130-mph winds sustained for six hours. We slowly got our things and moved into a one-room house where rain wasn't coming through the roof. We got the team together, assessed our own staff--we have 400 staff in the region--and helped them get on their feet. Most of them lost roofs; many lost families. This was a major task: We had no electricity, no water, no phone, no fuel, no access to money. We started by counting money in the safe, taking inventory of petrol, and getting in vehicles to drive around and talk to people, but this was difficult since 80 percent of the trees were ripped up (100-year-old oak-size trees). So sort of like on planes when they tell you to put on your oxygen mask before those of your children--we had a meeting, got our own staff up, and then turned towards others.

CNT: How many people does PSI currently have in Myanmar?

JH: We have 500 core staff, but when you count field outreach workers and those from the community who work with us on a daily basis, it's somewhere between 600 and 700.

CNT: What services did PSI provide before the cyclone hit?

JH: We're a health organization in Myanmar; we've been there for 12 years and it's a pretty broad program. There's a network of 800 private-sector doctors who deliver health care to low-income populations, addressing malaria, TB, pneumonia, reproductive health, and AIDS prevention, among other things. Beyond that network, we have around 22 drop-in centers for female sex workers and men who have sex with men (where we distribute condoms, provide sex education, etc.).

CNT: After the cyclone hit, how long did it take for PSI to respond?

JH: This is true of most organizations that were on the ground at the time: We were up and working on that Monday. Saturday was spent getting out of the house (the cyclone hit at 4 a.m. Saturday morning), Sunday was getting to the office, and Monday we had a crisis meeting, so within three days starting from Monday we were [reaching people]. By Wednesday we had been able to deliver enough water treatment products to a little under a million people. That doesn't mean they all got it yet, but that's the amount it treats. Having local production helps. We thought: What can we do? We're not a relief organization, but we have doctors already working there for free, so we set up systems to support them.

[PSI has a social marketing infrastructure in 300 of the 326 townships in Myanmar as well as its Sun Quality Health (SQH) network of private clinics in 126 townships. Over 300 SQH doctors are based in the affected region, and PSI is continuously providing them with essential medicines and health supplies so that they, too, can offer services for free during the crisis. A partnership with other INGOs is aiming to use multiple technologies (re-establishing access to tube wells, drilling tube wells, and treating water with WaterGuard) to make SQH clinics central sources of clean drinking water in their communities.]

CNT: What are the challenges when coping with a disaster of this magnitude?

JH: What are not challenges? It changes every single day; it's extremely intense. You have to make decisions very quickly, which is a different kind of work from our everyday work. You make rapid decisions without much information, breaking all the rules that you normally have. For instance, I gave out $100 to every staff member on the first day--that's 400 staff members, so $40,000--and I couldn't contact the headquarters, so I had no permission to do this. You just make decisions and figure it out afterwards. We had no fuel, no electricity, no telephone lines, and no email, but our mobile phones started working, so the whole relief community started using text messages. (It's a pretty interesting technology story.) Anyway, that was one way we overcame that challenge. We also kept core staff home for the first three days so we wouldn't use resources.

CNT: What is the difference between your organization and relief/Red Cross-type organizations?

JH: Because of the particular nature of Myanmar [and its government], it's very difficult to get access. We were able to respond quickly through the private sector because we were already there--us and some others in a similar position. But this isn't our normal business.

CNT: What have you been doing in D.C. the past couple of days? Have you been successful?

JH: I've been meeting with key decision makers related to Myanmar/Burma--people on the Hill, advocacy groups, etc. I've been telling people what we are doing in Myanmar to respond to this crisis. I've also been appealing for resources--although that wasn't my main purpose; it was mainly to share information--but we do need resources for this particular response. Our donors didn't pay to do cyclone relief.

CNT: What do your staff on the ground in Myanmar report about what the situation is like now?

JH: Latest reports: It's still pretty catastrophic, still disturbing, and we're still extremely concerned about the situation and immediate future for these people. We haven't been able to reach all of them yet; the international relief effort is not able to access all the areas that might be most effective. We're hugely concerned that it's the planting season now for rice--this is the rice bowl of Myanmar--and if they don't plant in the next couple of weeks, a far worse crisis in terms of food will arise in the future.

CNT: Through collaboration with the UN, other agencies, and INGOs, the Myanmar team has given away enough safe water solution for one million people to have clean water for one month. How else have you been successful?

JH: Through these private-sector doctors, who are working with the communities, we've been able to provide basic medicines, mosquito nets and malaria treatment, which will help prevent to a certain extent the spread of malaria. We're starting to see diarrheal issues and staff infections in children, though, and we're trying to address them as well as we can.

CNT: What do you think the role of a public health/developmental organization such as PSI should be in the face of a humanitarian crisis? And how do PSI's donors feel about the organization using their money for purposes they were not intended for, such as emergency relief work?

JH: We're not doing that; this is our own money. We're very careful about that. I think that you have to be humble, stick to your core, apply it to the emergency. It's very easy to get distracted because want to help people, but you must stick to your core confidency and do it in an emergency capacity. You're talking very easily about one or two million people here. You still have to be humble--we were humbled by the disaster, but you have to be clear about what you can and can't do. We have been successful in that. A lot of it involves saying no and then moving in a straight line.

CNT: How can people help PSI's efforts?

JH: We do have a donation "button" on the site; that money will go directly to this particular effort. This allows us to respond quickly in a way that normal negotiation contracts don't allow. The simplest way is to go to the site--in a financial way, I mean. Because of all the restrictions, volunteers would be difficult to get into the country.

CNT: What are your plans for the immediate future? And what are some of the major long-term health implications of Cyclone Nargis?

JH: We want to continue to produce and give away water treatment, and continue to consolidate and work through our private-sector doctors. There is a short term, a medium term, and a long term. We're already moving into planning the medium term, but I can't tell you what it's going to look like [because I don't know]. Long term, our concern is, as I said, the vulnerability of people without rice next year. And will disease outbreaks become overwhelming? Will more people die? The lack of sanitation, the conditions on the ground--we're all extremely concerned.

Further reading:
* Learn what Population Services International is all about
* How you can help PSI/Myanmar's relief efforts
* Make a Difference with Conde Nast Traveler bring simple life-saving solutions to children in need 

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