Maldives: Plan 2009-2010 (MAAMV001)

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Executive summary

The implementation of tsunami recovery programmes in Maldives since early 2005 has helped to establish goodwill and better understanding within the country about the humanitarian nature of the International Red Cross Red Crescent Movement. This understanding generated support for the formation of a Maldivian national society, a process which has been going on since September 2005. In June 2006, all Movement partners in the Maldives agreed on a common 'Maldives Red Cross and Red Crescent Tsunami Operation In-Country Strategy: 2006-08'. This strategy included long-term goals such as the formation of a Maldivian national society and the need to build better prepared and more resilient communities in the future.

In line with this strategy, in 2008 the International Federation launched the Maldives Appeal 2008-09 which outlined programmes that were focused on creating the environment for the establishment of a national Red Crescent society in the Maldives and enable it to start functioning and delivering services. The overall approach taken in developing the plan was based on an integrated context, anchored in a community-based approach. Implementation of programmes is ongoing and in line with the core areas of Red Cross Red Crescent work, alongside final work to conclude the formal establishment of the new national society.

Progress has been made by the integrated disaster management and health and care, organisational development and humanitarian values programmes during the first half of 2008 with tsunami funds. There are hopeful indications that the Maldivian Red Crescent formation process will be concluded by the end of 2008.

For the period 2009-10, the Federation secretariat's key areas of support will mainly focus on guiding the new Maldivian Red Crescent in designing and implementing longer-term programmes that are responsive to local vulnerabilities and focused on the areas where they can add the greatest value. Specifically, programme support will concentrate on the development of the national society, community disaster risk reduction, in line with the regional disaster risk reduction initiative "Building Safer Communities" that promotes the disaster risk reduction approach among all national societies in the region), community-based first aid, community health awareness, and promotion of the fundamental principles and humanitarian values. These programmes are based on the International Federation's Strategy 2010 and are geared towards achieving the Global Agenda goals, which will in turn contribute to the achievement of the Millennium Development goals.

Formal existence of the Maldivian Red Crescent will see the role of the International Federation's delegation in the Maldives shift from an 'implementer' to 'facilitator', putting effort on nurturing and developing the new national society. In addition to direct programme support, the delegation will provide support in governance, advocacy, representation, branch development, finance management, communications, planning, monitoring, evaluation and reporting (PMER), information technology and services to partner national societies. There will also be the need to support the new society in recruiting, training, retaining and managing a diverse, gender-balanced staff team across all programmes.

The plan for the coming two years is based on the assessment that the national society formation process will come to a successful conclusion later this year. The optimal management and long-term sustainability of the programmes outlined below is also premised on the same. The programmes aim to directly assist staff and volunteers of the new Maldivian Red Crescent and 40,000 people across the Maldives.

Total budget for 2009 is CHF 2,873,500 (USD 2,626,600 or EUR 1,830,255) and for 2010 is CHF 1,832,086 (USD 1,674,667 or EUR 1,166,933)

Country context

The Maldives is a country of 300,000(1) people spread over 199 inhabited islands. More than half of the population lives on islands with a total population of less than 1,000 while over 100,000 people (a third of the country's population) live in the two square kilometres that is the capital city of Male - making it one of the most densely populated places in the world. The wide and uneven distribution of the population poses many challenges, including the high unit cost of providing social and economic services. There is also a large disparity in income between Male and the outlying atolls.

According to the 2006 census, the total employment in the country stood at 110,231, a 28 percent increase from the 2000 census. However, the unemployment rate has since increased significantly from 2 percent to 14 percent, as around 41,766 people entered the labour market. The high unemployment rate reflects structural issues in the labour market rather than a lack of job opportunities(2). The expatriate workforce in the country has increased exponentially over the past three years, with expatriate employment annual growth rate indicators from the Ministry of Higher Education, Employment and Social Security showing that it was close to 70,100 as at end of 2007(3).

While the Maldives' health standard is generally good and significant achievements have been made in the control of communicable diseases, non-communicable diseases - including lifestyle-related diseases - pose a major challenge for the health services. The threat of avian and human influenza in the world also needs to be addressed in advance in the country. Acute respiratory infections and viral fever are some of the most common causes of morbidity. The high prevalence of thalassaemia (inherited form of anaemia whereby the blood cells are unable to carry a sufficient

supply of oxygen for the body's needs) continues to be a major challenge for the country, with approximately one sixth of the population affected by the condition. This makes it one of the highest incidences of the disease in the world(4).

Efforts are needed to control and prevent vector-related diseases such as dengue and chikungunya as sporadic cases have been reported over the past six months. A total of 1,022 cases of dengue were recorded during the period 30 December 2007 to 28 June 2008 (407 in the atolls and 615 in Male).(5)

The department of public health, Ministry of Health, has strengthened vector control, including thorough inspections and chemical spraying. Vector control teams continued their regular inspection of household/premises in Male; health education continued to be carried out and appropriate measures on identified breeding places were taken. The American Red Cross and British Red Cross also continued health promotion activities as part of their tsunami recovery programmes, stressing on prevention of dengue and chikungunya through eradication of potential mosquito breeding grounds.

On the social front, urban violence and an increase in drug abuse continue to present huge challenges to law enforcement units and the Narcotics Control Board respectively. In the early months of 2008, there was a dramatic increase in the number of gang fights and gang-related attacks on the streets of Male. The situation deteriorated to the extent that the Maldivian National Defence Force (MNDF) - the country's armed force - was tasked to conduct a special operation to tackle gang violence. The operation was deemed successful as it saw a significant drop in violence. Recently, a number of the main street gangs called a press conference where they announced a peace treaty.

Related to urban violence is the issue of drug abuse. The Narcotics Control Board (NCB) appreciates that this relatively recent phenomenon in the country (and the increasing incidence of drug-related arrests) is becoming a national concern. The drug problem also presents challenges to the health sector, particularly in the prevention of HIV and AIDS.

In 2003, the NCB conducted a rapid situation assessment of the drug scenario so as to inform policy direction. A majority of the unmarried respondents (75 percent) reported a sexual experience, and 68 percent of the married respondents reported an extramarital sexual experience. Drug use with a member of the opposite sex was reported commonly (65 percent), and this was usually in the context of a sexual relationship. Less than one third (30 percent) of respondents reported consistent condom use; although many of the respondents were aware of some of the common modes of spread of HIV, a majority (73 percent) did not perceive being at risk for the infection(6).

The first HIV case in the Maldives was identified in late 1991. As of 31 December 2005, the reported number of Maldivians with HIV was 13 (in the 20 to 49 age group), of whom ten have died of AIDSrelated diseases. Reported cases of foreigners infected with HIV as of 31 December 2005 was 168(7). Although the number of reported people living with HIV in the Maldives is very small, the country faces a challenge of ensuring sustained low HIV prevalence. Effort is required to further strengthen awareness programmes. The introduction of voluntary testing and counselling is a major positive step towards better surveillance and management of HIV and AIDS. Special challenges include reaching and assessing the sexual behaviour of high-risk populations such as intravenous drug users and the constantly increasing number of the expatriate workforce.

The larger operational environment over the past two years has been characterized by some political tensions. In 2006, the government embarked on extensive reforms to the nation's political and institutional framework. The reforms were outlined in the 'Roadmap for the Reform Agenda' which also envisaged the revision of the Constitution prior to the country's first multi-party elections scheduled for late 2008. The reform programme was first announced by the president in November 2003 upon assuming office for a sixth term. Its basis was the Vision 2020 which envisages the Maldives becoming not only economically prosperous but also politically democratic/mature within 20 years. A strategic plan to implement that vision was published in October 2002, and included, among others, increasing engagement with the international community. In October 2004 - two months before the tsunami struck - the government of Maldives signed a formal agreement with the International Committee of the Red Cross (ICRC), under which the ICRC was granted access to prisons in the country.

While reforms in some areas saw some significant progress as at mid 2008, constitutional reforms proved difficult and slow. Pressure was mounting for the government to ensure that expectations for competitive and multi-party politics are met, specifically through the enactment of a new/revised constitution. On 7 August 2008, the country's president ratified a new/revised constitution. Realignment of the government structure in view of the constitution could potentially affect implementation of programme activities. For instance, heads of government departments who simultaneously served as members of parliament are to give up their positions in either. This means that if a departmental head [who functioned as the focal person for some area of programming] opts for parliament, there will be a chasm left until a replacement is appointed.

Prior to the December 2004 tsunami, the Maldives had little direct experience of the effect of major natural disasters. In communities within which its impact was greatest, the tsunami cancelled out development gains accrued through years of patient endeavour and highlighted a need for comprehensive risk reduction measures linked to effective disaster preparedness systems. It exposed a need for disaster management to be regarded as the responsibility of everyone.

The disaster risk scenario for Maldives can be described as moderate, with the main hazard faced being sea swells that occasionally cause severe flooding on account of the low lying nature of the islands. Being a low-lying, small island country where more than 80 percent of the land is less than 1.5 metres above mean sea level, the Maldives is one of the nations most vulnerable to predicted global environmental challenges. The projected rise in sea levels threatens the existence of the nation and the projected increases in sea surface temperature due to climate change and climate variability threaten the health of the coral reef ecosystem on which the two key economic sectors - tourism and fisheries - are based. Higher frequency and intensity of extreme events could cause severe flooding and significant damage to islands where flooding is already a challenge.

The devastation brought by the tsunami saw a swift response by Movement partners. In the absence of a Maldivian national society, the government of the Maldives became the main partner in implementing Red Cross Red Crescent relief and recovery programmes valued at over CHF 180 million. Since then, the International Federation has continued working with the National Disaster Management Centre (NDMC) in strengthening institutional arrangements and capacities to deal with disasters, particularly because preparedness of the government to cope with small to medium-scale disasters was limited prior to the tsunami. Additionally, due to the relatively high vulnerability of small, scattered island communities, the need for building community-based disaster management capacities is essential, in line with the regional initiative on "building safer communities", which is related to the DRR approach and climate change, following the Hyogo Framework for Action. Consequently, the new national society must mobilize volunteers, train community members and build community resilience, as well as play other important roles as an auxiliary to the government.