Examination of Witnesses (Question Numbers
21-39)
MR ROB
REES, MR
WILLIAM ANDERSON
AND MR
JUSTIN BYWORTH
26 JANUARY 2010
Q21 Chairman: Can I say welcome to
you and thank you very much for coming in. You will probably appreciate
that we are slightly pressed for time and one or two colleagues
may have to leave. We want to hear from you and if you can be
crisp in your answers that would be helpful but please tell us
what you think we need to hear. You have been in before and heard
what has been going on in the previous session. I will start with
what DFID has been doing with its Protracted Relief Programme
but, firstly, could you introduce yourself for the record.
Mr Anderson: I am William Anderson.
Mr Byworth: I am Justin Byworth
from World Vision.
Mr Rees: I am Rob Rees from CAFOD.
Q22 Chairman: DFID ran this Protracted
Relief Programme I and II which attracted some degree of support.
How effective has it been? What have its problems been? What do
you think they could or should have learned which might help inform
the next stage?
Mr Anderson: Let me just make
a quick point. Overall, I think DFID has a very good programme
in Zimbabwe. I think DFID has responded to the needs very well.
It has set the agenda for all other donors really, so we should
be very proud of what DFID is doing in Zimbabwe in a very difficult
situation. The Protracted Relief Programme is the flagship programme
of DFID particularly related to secure livelihoods. It is a key
part of humanitarian plus, as it were. It is not really relief
but it is recovery and in many ways development. We are in the
second phase of the PRP. We have had three years and then a review
period and now we are in the second three-year period, or possibly
five years. I would say that it is an extremely good programme.
Other donors really want to come on board and support it. One
particular aspect of it, if I can come straight on to that, is
conservation agriculture. DFID has supported conservation agriculture
since 2002. It has supported a task force in Zimbabwe on conservation
agriculture. It has supported a manual that is now out. It has
done this to some opposition within Zimbabwe. There were a few
agricultural academics who said that conservation agriculture
does not work, particularly in the drier parts of the country.
These academics have now been proved to be wrong and they have
said that this is the best agricultural practice. In that respect,
DFID has stuck to their guns and I think it is an excellent agricultural
practice that should be promoted across Africa. I would like to
see DFID promote that much more.
Mr Byworth: I agree with everything
that William has said. I think PRP is a flagship programme that
DFID should be proud of. World Vision and others as partners of
that have seen real impact in the lives of communities that we
are working with. One particular aspect of it that we welcome
is its focus on the vulnerable, including vulnerable children,
combined with a focus on livelihoods to lift up the communities,
through such things as conservation agriculture, together with
safety net and social protection programming to support those
who are most vulnerable.
Q23 Chairman: Could you explain that
a bit more, though, because this is in a country where the Government
has been crashing around destroying things all over the place.
To what extent can they be sure that this sticks? What has been
the reaction of the Government to this if then they decide they
want to work in an area or displace people? Has that happened
or how have they managed to protect it?
Mr Byworth: Certainly where World
Vision is working is at that interface between community and the
lowest tier of government, particularly government service deliveries
in health and education. In those places obviously in the last
12 months we have seen real progress on that in terms of staff
being there and able to deliver those basic services, so certainly
we are more hopeful about that now than we were 12 to 18 months
ago. Of course the future is uncertain.
Q24 Chairman: Are there no-go areas,
parts of the country you just would not go?
Mr Byworth: Not for World Vision.
We have been working in several parts all around the periphery
of the country and we do not have that issue, certainly not recently
since the NGO ban, but that was a different matter.
Mr Rees: I would endorse what
they have said about the programme overall. Just a slight comment
though on the way that the programme is managed through a contracting
agency, GRM. We recognise that DFID needs to minimise transaction
costs and save its own costs, but there is a feeling that it increases
the distance between civil society organisations that are actually
implementing the programme on the ground and the donor. Through
the partners that we work with they would like to feel that they
have some opportunity for more direct contact with DFID in order
to be able to get a better understanding and to ensure that DFID
has a good understanding of the situation that they are working
in. This applies to a certain extent in the health sector as well.
At the time of the cholera crisis DFID gave the funds for the
response to cholera all to UNICEF and there were a lot of delays
subsequently in the provision of the relief assistance. Generally,
we think that there should be some improvements in the means of
communication and dialogue between civil society and DFID.
Chairman: Thank you for that.
Q25 Richard Burden: On the same area
of DFID programmes around agriculture, it is good to hear what
you say about the conservation agriculture programme. DFID's work
in terms of improving agricultural productivity has also been
praised. Are there any ways that you think that that work can
be improved upon and built upon for the future? I take your point
about GRM as well, about mechanisms for distributing support to
small farmers.
Mr Anderson: The key part of conservation
agriculture is teaching people how to better manage their land
and how to get a profitable harvest. The national average in Zimbabwe
is 0.2 metric tonnes per hectare. For a family of six just to
be subsistent they will need 1.2 metric tonnes per annum of grain.
The conservation agriculture practice enables households to get
at least 2, 3, 5 and in many cases over 10 metric tonnes per hectare.
That is in ideal conditions. This then comes to a point where
once you have got a good harvest what do you do with that maize,
sorghum or millet? That is where we need to address the issue
of market because if you cannot sell the maize, in particular,
then that household is not able to use it. It is going beyond
that and thinking about storage and about markets and about better
crops, better grain, more suitable to the areas. People do prefer
maize. Sorghum, millet and cassava are promoted by DFID and perhaps
it is looking into this as well, how can we get across the idea
that for dry areas these are the crops that are much more suitable.
DFID is doing this but perhaps they can be nudged in that direction
further. It is certainly not off their radar; it is on their radar.
Mr Byworth: One point to add in
terms of building on that, I think it is important also in supporting
agricultural development and greater food production to link from
that into the area of nutrition. Obviously even where you have
higher yields and higher consumption, it does not automatically
translate into better nutrition for children and women. There
have been examples of other projects, Healthy Harvests for example
with UNICEF, where that work has been combined with greater education
on good nutritional practice in the home, and certainly World
Vision would advocate that a link is made between the agricultural-based
programmes with also the child-focused vulnerable programmes to
improve child nutrition. The levels of chronic malnutrition and
stunting in young adults in Zimbabwe is horrendous. It is huge
although the acute wasting malnutrition is not so high. I believe
they are just doing a nationwide nutrition survey at the moment
and UNICEF and many other agencies are involved in that. We should
make the link from agricultural production to nutrition, particularly
for children.
Mr Rees: Conservation farming
is aimed at making better use of resources and particularly rainfall,
but at the end of the day the overall productivity will depend
on a successful rainy season. Just at the moment there is a very
big fear that the rains have stopped. There has been a three-week
break in the rains in many places and yields are going to be greatly
reduced and possibly be in total failure unless they resume. This
then adds additional complications because farmers have taken
resources, fertilisers and seeds on credit and the question is
whether they are going to be expected to repay those loans even
though they have no harvest and how they will do that. It raises
the issue of land and land ownership, which is quite a critical
factor in the matrix.
Mr Byworth: I think next week
some of you will be there. I was there 10 days ago and I saw literally
the contrast where the conservation farming had been applied or
not in terms of surviving the period without rain. I have not
heard good news that there has been rain, but I heard from some
farmers and they said last year they had good rains and a better
harvest but because of the economic and political situation they
did not have access to the inputs; this year they have access
to the inputs and now they have no rain.
Q26 Chairman: The Committee has a
reputation for finding the rain.
Mr Byworth: That is fantastic.
The rainmakers!
Mr Anderson: I have a couple of
points, harking back to what was said before. One is about internally
displaced persons. That is a term that cannot be used in Zimbabwe
by agencies because the Government does not like it—they
prefer "mobile vulnerable population"—but DFID
has been consistent in its support of internally displaced persons
(IDPs), and the work that they do with the International Organisation
for Migration (IOM) should be commended as well. I hope you are
going to look at that. It comes on to the point about how they
support some of the displaced persons perhaps from Murambatsvina
in communities and the existing communities there. Over a period
of time the support went just to those displaced persons, which
caused conflict and tension in the community. But now through
IOM, with DFID support and with other NGOs, the support is more
holistic, so lessons have been learned along the way as well,
just to add that point. Another point is that at the local government
level often the local government really wants the NGOs with DFID
support to be there. They will be falling over themselves to get
in the NGO support. They really want the support from NGOs. It
is very different to the message of the national government. I
think that is a key point as well. NGOs were really only banned
for those few weeks after the first election in 2008. There was
a ban and we were not able to operate but since then, I think
across the country, NGOs do have access at the moment. At election
time that becomes restricted and few field staff will be able
to visit those areas. That is for three or four weeks before the
election.
Q27 Hugh Bayley: As the health system
has contracted health needs have increased. What can be done to
recruit and retain and, dare I say, repatriate health staff?
Mr Byworth: That is a very good
question. Obviously there is an international dimension on which
I do not think myself and World Vision are best-placed to comment
in terms of the diaspora, for example, in the UK. Certainly having
just been there, I was encouraged that staff—and I visited
three health clinics all in southern Matabeleland—had returned
to work again in the last 12 months and were being paid and were
working. Certainly we have seen an improvement in that. Obviously
there is a huge reliance on local community-based volunteers.
Whether it is on caring for people living with HIV or whether
it is on outreach programmes for children, there is a huge reliance
on local volunteers where NGOs like World Vision and others can
help link up to the system. Obviously one long-term policy issue
we would like to see is access free at the point of service, free
at the point of use. Access to health care does not exist and
obviously, although economically things are much better now in
a dollarized economy, prices, although they have dropped a little
in the last couple of months, are still high and the cost both
for the recipient and also for staff with salaries the way they
are is a struggle. Long-term you need a strong health system top
to bottom, but we recognise the constraints in addressing that
in terms of government-to-government.
Q28 Andrew Stunell: If I could just
pick up the specifics of the HIV programme where DFID has allocated
£40 million over the next five years. Do you think DFID's
focus on that is correct? Is it working? What would you say about
the programme itself and the outcomes we might expect to see?
Mr Rees: I would say it is a major
priority and DFID does have its level of commitment right. Zimbabwe
now has one of the lowest levels of life expectancy of anywhere
in Africa. It is 34 years for a male and 37 years for a female,
with over one million orphans estimated across the country. I
think there are questions, as was mentioned a moment ago, about
access to health services since the dollarization. People in rural
areas particularly have very limited opportunity for accessing
hard currency and therefore have limited access to health services,
which then raises a question of access to and distribution of
the antiretrovirals (ARVs) and how the costs of distributing those
will be covered.
Q29 Andrew Stunell: What about the
vulnerable and marginalised groups?
Mr Byworth: As you mentioned,
particularly the orphans and households made vulnerable by HIV,
the scale of it is just immense. DFID has responded well to it.
I think the programme of support that they have given through
UNICEF has been very well received and well used. I think it is
completing later this year in 2010, so we would certainly encourage
DFID to look at continuing that. Rob mentioned earlier that UNICEF
in terms of an intermediary and a grant-making body to NGOs and
civil society has not been set up to do that as efficiently, say,
as GRM have done for the PRP, so I think they either need some
support to get better—we have had all kinds of problems
with procurement through them—or look at an alternative
intermediary. We certainly support what UNICEF is doing there
and the DFID work with UNICEF. Although HIV prevalence rates have
reduced, the numbers of orphans and those affected has increased,
so it is going to be many years that this needs to be continued
for.
Mr Rees: Within the work that
we do under PRP with DFID support we try to prioritise families
and communities that are affected by HIV, so single-parent families
particularly and those mothers who are HIV positive will be given
preferential treatment and access to support through that programme.
It is a matter of targeting assistance to try to encourage and
maintain self-reliance within the family and within the community
because the problem is so big that institutions are not the response.
Q30 Andrew Stunell: Compared to other
African countries, the amount of aid going in for HIV projects
appears to be lower. Is that a function of the instability or
is there government resistance or have we just not got round to
it?
Mr Anderson: Lower than what?
I think one of the reasons why there is not a huge amount of money
is because of some of the large foundations, for example the Bill
Gates Foundation and PEPFAR[5],
which are supporting Zimbabwe at the moment. In terms of the priority
of HIV/AIDS, it is a huge issue and DFID is right to concentrate
on it. Coming back to the prevalence, it was about 25% five years
ago and it has now come down to about 16%. That is attributed
partly due to behaviour change, and I think DFID's role in that
can be evidenced. It is also partly due to the number of people
who have died. There are 3,000 people dying every week from AIDS-related
illnesses. In terms of the actual support, there is also an organisation
called Population Services International (PSI). Again that is
with USAID so DFID has done well to co-ordinate its funding of
that with another large donor. I think that is a good programme
as well. I am not qualified to talk about it but it is something
you can certainly look into. There is an Extended Support Programme
which is considerable in Zimbabwe. They work through the Government,
the Ministry of Health, as well as large UN agencies and larger
NGOs. Again that is a huge programme that I am not qualified to
talk about but I would suggest you look into it as well. In terms
of the priority of HIV, it is a huge issue and they are right
to do that.
Mr Byworth: We certainly have
not come across the social stigma that was there some years ago
or a "head in the sand" political mentality about this.
That has not been an issue that we have encountered locally. Programmes
are able to be effective there but the need is huge. There is
a great link with cross-border migration as well, with South Africa
particularly, which complicates things.
Q31 Mr Sharma: In the last few years
the child mortality rate has increased. What are the main causes
of that and illness in the country and how do you then go about
addressing these issues?
Mr Rees: I think it is a combination
of factors reflecting the chaos that has prevailed within the
country and within the primary health care sector: the reduction
of the number of medical staff, the trained nurses and doctors
who have left the country, so there are not the personnel on the
ground to provide the services; lack of basic supplies; the inability
of the poorer sectors of the community to be able to pay for the
services. Especially pre-dollarization where prices were going
up by the minute, then it was a very difficult situation for anybody
to plan ahead for and to be able to make the necessary allowances
in terms of their own personal expenditure.
Mr Byworth: Certainly under-five
child mortality is an absolute top priority. World Vision has
a global campaign on that at the moment to try and reduce the
8.8 million child deaths each year, to try and reduce the 6 million
or so of those which are largely preventable. Certainly in Zimbabwe
the major childhood killers are there to see—diarrhoea,
respiratory infections, malaria, et cetera. Poor hygiene and access
to water and sanitation is a major factor. Poor nutrition is a
major contributing factor underlying the vulnerability which leads
from not getting access to health care. When you do not get access
to health care it has more damaging effects. Certainly we would
like to see a redoubling of focus on both the maternal and child
health Millennium Development Goals not just for Zimbabwe but
for all countries where child mortality is high. There are about
30 what we call "high burden" countries which have the
largest percentage and largest number of children under five who
die. Zimbabwe needs to be right up there with a big strong focus
on it, both through strengthening health systems and community-based
measures. A lot of times with child mortality it is simple, community-based
preventative measures such as re-hydration for diarrhoea and those
types of things that are proven to reduce mortality. If you look
at Malawi just across the border, child mortality has improved
significantly in the last few years in contrast to Zimbabwe and
a few places like Kenya. It gets strong investment but it needs
to be both community-based and also health strengthening. DFID
is well placed on that at a policy level through the International
Health Partnership they have been promoting A bit of a stronger
capacity for DFID in country in Zimbabwe on health would be good.
They are not as strong as perhaps they might be.
Mr Anderson: It is due to the
breakdown of Zimbabwean society and the social services structures.
It is as basic as that.
Q32 Mr Sharma: You did mention that
poor child health is due to malnutrition. How effective has the
food aid programme been in tackling it?
Mr Anderson: Food aid now through
the World Food Programme has been going on for eight years and
there are very good things in that it has stopped people from
dying. It has operated during the hunger gap period from around
November/December to around March/April when the harvests come
in. I would say it has saved lives. In terms of how we can improve
that, I would suggest that there are areas that WFP should be
looking at and nudged by DFID, particularly food for work, because
simple food aid for eight years on the trot does induce dependency
on food aid and people perhaps might decide just to take the bag
of food at the end of the month rather than try to grow their
own food. There are also things like issuing worm tablets. It
is a very simple operational activity to issue worm tablets with
the food aid. There are lots of other things that could be done
like that to support the food aid. In general, I think the World
Food Programme could be held a little bit more to account by DFID.
NGOs are under strict accountable measures through the GRM and
the TLC. The TLC is very good and they have certainly improved
the capacity of international and national NGOs in particular.
It would be nice to see a bit more accountability for UN structures
as well.
Mr Byworth: World Vision has partnered
with the World Food Programme and also the USAID food programme
as significant suppliers of food aid for the whole of that period,
so certainly we can attest first-hand to lives being saved through
that, but we would also agree that with conditions economically
improving, there needs to be a move (which has happened) to greater
targeting of the most vulnerable because even if you move away
from general food distributions, which has not yet happened and
probably cannot yet happen fully but needs to happen over the
coming years, you are going to still need some targeted food assistance
for particularly vulnerable groups. Yes, there will need to be
a move towards more livelihood-based use of food such as food
for work and to combine that with agricultural development programmes
to reduce dependency. I would not say it is time to stop yet but
it is time to start the transition to a more targeted and more
livelihoods-based approach. Definitely that transition needs to
happen. DFID's view on that has been largely correct. Even in
the PRP they are pushing for a more economically viable approach
to recovery now, which again the conditions allow for more now
than they did 12 or 18 months ago.
Q33 John Battle: Just as infant mortality
is rising maternal mortality is rising as well and DFID has taken
some actions to try and decrease the rising rate of maternal mortality.
Is it successful? Is it helping?
Mr Byworth: Not sure is the answer.
Mr Anderson: I do not know but
just as an anecdote, private hospitals were extremely good in
Zimbabwe but even in private hospitals now, due to the collapse
of the system, there are not enough medicines to go around, certainly
not enough staff, so even if you wanted private expensive medical
care in Zimbabwe you might be thinking about going down to Johannesburg.
At the community level/communal level outside of these private
hospitals you have very little to support you.
Mr Byworth: Certainly World Vision
is not as involved with maternal health except in as much as the
link with that and child and neonatal health particularly. I know
the number of women having deliveries at home is very high. Up
until the last couple of years it is 40% or something like that.
The number of skilled birth attendants is not enough and access
because of distances to travel are difficult. Again anecdotally,
I saw women come for ante-natal check-ups just 10 days ago at
a clinic in Matabeleland, and there was a women who had had a
baby two years before, and she contrasted that experience with
the child that she had with her of four months on her knee and
she talked about the difference of both access for delivery at
the health centre more recently and also access to immunisation
and child monitoring. She talked of a real difference and a real
improvement between her second child who was a baby and her first
child who was two/two and half. That is anecdotal. In terms of
DFID's impact I do not have any evidence.
Q34 John Battle: DFID themselves
highlight the high rate of contraceptive use in Zimbabwe. Has
that made a big difference?
Mr Byworth: It links to PSI perhaps.
Mr Anderson: I do not know the
PSI programme.
Mr Byworth: They talk about the
high rate of female condom usage in Zimbabwe more than almost
any other country in sub-Saharan Africa, I believe, but I do not
have any first-hand evidence of that.
Q35 Hugh Bayley: What were the causes
of the cholera outbreak last year? Are you expecting another outbreak
this year? What should DFID be supporting in terms of promoting
better public health and hygiene?
Mr Anderson: Cholera has always
been in Zimbabwe. Every year there are a number of deaths. This
year seven people have died officially from cholera. Last year
was an epidemic waiting to happen really. It was the result again
of the breakdown of social services, very bad sanitation in high-density
suburban areas and very poor living conditions. It was going to
happen really and it was talked about at various humanitarian
agency co-ordination strategy working groups even before it broke
out. We were discussing it before it happened so we knew it was
coming, in a way. In terms of what DFID could do further, it is
all about community-based improvement of sanitation at the moment
because local government do not have the funding to improve these
services. DFID needs to work out how—and you talked about
it in the earlier session as well—to support local government
in that and how to support the community in that.
Mr Rees: In the longer term there
has to be major rehabilitation of the infrastructure. Community-based
responses really are just short-term measures, particularly in
densely populated areas like Harare and the suburbs. It is a project
for the future to rehabilitate both the sewerage and water supply
systems which will then provide the protection that will be needed.
Q36 Hugh Bayley: I can see the need
for the immediate response and I can see that that is possible
now but what political conditions would you need for major infrastructure
projects to be viable?
Mr Rees: It will be dependent
upon economic recovery within the country and, as William alluded
to, the financial resources being committed by the national government,
whether it is from its own internally generated income or whether
it is through aid packages after the resumption of normal aid
and financial support from the international financial institutions.
As I say, that is an issue to be dealt with in the future when
those basic economic and political questions have been addressed.
Q37 Hugh Bayley: Can I ask a slightly
wider question. It is a chicken and egg situation, is it not?
If you wait until conditions are right, conditions will never
be right. Politics is about a process of moving from the dire
position you are in to a better position. How does the nexus of
aid and politics help you? In other words, should you be planning
this now and how would you plan it now? Should you be telling
a big infrastructure player like the EU to put together a programme?
How do you get to a position where you can improve infrastructure
in a relatively near timescale?
Mr Anderson: There is a recovery
plan and DFID was part of producing that. It was based on the
Hague Principles in October 2007 and then a major donor meeting
in Ottawa last year. It is all to do with, as we were discussing
in the first session, whether the Government of Zimbabwe is really
there for its people or there for itself. Unless that has been
addressed, that is a fundamental issue where, no matter what is
poured in, it might not work, it might not be targeted, it might
be liable for corruption. In terms of improving these services,
yes, DFID has to work as far as it can but make sure that there
are certain benchmarks which they have already got in writing
that are met. At this time the Hague Principles are not met and
most of those benchmarks are not being met and so therefore withhold
the funding and hopefully if these benchmarks are starting to
be met then release some of the funding but, yes, it is very difficult.
Q38 Andrew Stunell: Can we just take
a look at education and children. The DFID allocation is 2% of
aid going to education. There has been talk about schools getting
back to work and so on and yet there are clearly some priority
areas. Could you just comment on the amount of money that DFID
is allocating and the effectiveness of what it is doing. Are we
short of teachers? Are we short of buildings? Are we short of
security? What do you see as being the problems or perhaps there
are not any problems?
Mr Rees: All of the above, I would
say. There is a shortage of teachers. Along with health professionals
many teachers have migrated out of the country. I heard an interesting
report that some of the best education in the countries around
Zimbabwe is provided in schools where there are Zimbabwe exiled
teachers. In the past Zimbabwe had a very high standard of education
and a very high standard of teaching. Quite rightly it was proud
of it. As with health professionals, some system and some opportunities
need to be created to bring those professionals back into Zimbabwe
to support the schools. There needs to be investment in schools
and in school materials in the same way that there needs to be
investment in primary health care facilities as well, particularly
in the rural areas.
Q39 Andrew Stunell: So do you think
this is something which can come through the state or DFID can
only contribute through the state? In terms of the amount being
given, 2% of DFID's money is going to education; is that about
right, is it too much or too little?
Mr Anderson: I do not know. In
terms of the Ministry of Education, it is run by David Coltart
at the moment. He was the only MDC MP not to accept a brand new
Mercedes Benz when he took office. He is trying to drive out corruption
but again his hands are in effect tied to a large extent because
of the political deadlock between ZANU-PF and the MDC. He is also
completely tied by the fact that teachers are not paid so they
want to go to South Africa and get a proper salary. I do not know
whether the 2% is right or not but it is certainly a huge area.
Mr Rees: I do not think there
is any country in Africa where there is enough investment in education.
There is always a need for more.
Mr Anderson: I think in 1980 ZANU-PF
said that they were going to provide free primary education. We
have not seen that to date.
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