Field Exchange No. 50 (August 2015)
As this half centenary issue of Field Exchange contains a number of guest editorials by individuals who were involved in Field Exchange from the start, we are going to keep this one short. It is pretty much 20 years since the idea of a Field Exchange and the ENN was mooted at an inter-agency conference in Addis Ababa. A throw away comment by Helen Young at the meeting planted the seed of an idea; Helen remarked that the Addis meeting was unusually productive as it brought together field practitioners, academics and donors who could all learn from each-other and wouldn’t it be great if we could find a forum to enable this kind of ‘exchange’ to take place more regularly. The acorn tree that is now Field Exchange and the ENN grew from this one comment.
For the editors of Field Exchange, there has always been one core principle that has held sway. It is that the written word has unique value. Emerging from the ashes of the Great Lakes emergency in 1994/5 where mistakes and learning from previous decades appear not to have been heeded, Field Exchange was predicated on the realisation that institutional memory is fragile and that the written word can uniquely preserve learning. There is nothing wrong with the ‘oral tradition’ but memories are fallible in a way that the written word is not.
Over the 20 years of editing Field Exchange, we have also come to see how the process of writing up field experiences adds value. Those who put pen to paper are compelled to organize their thoughts and learning logically, to self-examine and to make only claims or recommendations that can be supported by written evidence which in turn can be scrutinised by others. Elements of learning that take place through the writing process would almost certainly not occur if simply recounted orally. The written word promotes accountability for what is said. Furthermore, it enables dissemination of learning at scale. The ENN has also learnt that even in situations where draft articles are withdrawn from publication (very othen for reasons of sensitivity and risk to programmers), the very process of writing has enabled the authors(s) and their organisation(s) to learn from the programme experience even though this learning may not be disseminated more widely.
Whether the written word appears in print or digitally is perhaps less important but is still relevant. Many of our readers only have limited or expensive online access. Furthermore, it is notable (if not a little surprising) to find in Field Exchange evaluations that our readers still have a strong attachment to the hard copy even when they have online access. Flicking through the pages of Field Exchange in a life that is dominated by ‘screen time’ for many may well be a welcome relief and a better reading (and learning) experience. We, of course, now produce Field Exchange (and its sister publication Nutrition Exchange) both in print, e-copy and online: we also plan to embrace multi-media developments, which may allow for wider and cheaper dissemination to our readership Over the years, the ENN has expanded into a range of activities including technical reviews, operational research, technical meeting facilitation, and development of guidance and training material.
Our activities are largely informed by from the privileged overview of the sector we obtain through pulling together Field Exchange. This expanded scope of work is thus a product of your work in contributing to the publication. Field Exchange has therefore been, and remains, the cornerstone of what ENN does.
On to the edition in hand; as ever, we have a wide range of articles covering innovations and challenges in programming. A special section looks at lessons and plans for delivering treatment of severe acute malnutrition (SAM) at scale in Northern Nigeria, with three articles by UNICEF/ACF/Mark Myatt; ACF; and Results for Development (R4D) on the topics of coverage, costs, cost-effectiveness and financial sustainability of CMAM. This includes a proposed sampling based approach to estimate the number of deaths averted by the Nigerian CMAM programme which is accompanied by two ‘peer review’ postscripts.
An editorial by CIFF, a lead investor in the Northern Nigerian CMAM programming, introduces the section. Also on the theme of CMAM in Nigeria, an article by MSF documents malnutrition peaks associated with malaria peaks and highlights the fact that medical care typically does not come under CMAM funding, is implemented by different ministries and agencies and is often under resourced.
The logistical challenges of nutrition programming are reflected in an article from South Sudan by ACF, UNICEF and CDC, which describes the technical innovations that enabled nutrition surveillance in a vulnerable but quite inaccessible population. The response to flooding in Malawi in early 2015 is the topic of another article around CMAM by Concern. Whilst providing immediate support, they found lack of surge capacity and sub-standard existing SAM treatment services, despite longstanding external investment in the recent past. How to sustain long term CMAM programming once the NGOs ‘go home’, remains the 'million dollar question'.
At the other end of the spectrum, an article by Help Age International describes the burden of care and experiences of non-communicable disease (NCD) programming in Lebanon amongst older Syrian refugees and vulnerable Lebanese. It reflects there is progress but a lot yet to be done to meet NCD and associated nutrition needs in humanitarian programming. The remaining articles cover a range of topics – infant feeding support in the Philippines from the perspective of a local NGO responding to Typhoon Haiyan in 2013; experiences of the Sustainable Nutrition and Agriculture Promotion (SNAP) programme in the Ebola response in Sierra Leone authored by IMC and ACDI-VOCA; and UNICEF experiences of a combined SMARTSQUEAC survey in Chad that saved on time and costs.
We have a run on views pieces in this edition, as well as a rich mixture of research summaries.
An article by Ajay Kumar Sinha, Dolon Bhattacharyya and Raj Bhandari on the challenges of undernutrition in India provides a fascinating insight into the complexities of national and sub-national programming and highlights the need for coordinated actions. India also features in a research summary from MSF that shares great insights into community perceptions and behaviour around SAM treatment in Bihar. Resilience and nutrition is the topic of an article by Jan Eijkenaar which provides insights into the ECHO funded Global Alliance for Resilience Initiative in the Sahel. There are also some must read articles on accountability to affected populations, a topic that hasn’t featured strongly in Field Exchange in the past and to which we all too easily pay ‘lip service’. One piece describes ground breaking work in the Philippines by Margie Buchanan-Smith et al and the other is a very personal but experience based viewpoint by Andy Featherstone on progress and pitfalls around accountability over the last 20 years or so.
As a final word, we would like to thank all those authors who have written material for Field Exchange in the past and encourage those who are thinking about writing in the future to get in touch with us to discuss potential topics. We are here to support you in many different ways, from a ‘brainstorming’ conversation to review of a fledgling idea to editing. In this issue, we’ve included a guide to the process to help. Over the years, our content has become more ‘technical’ but we welcome more informal contributions too; it is great to see a few letters in this edition and we would love to receive more.
We would also like to thank our many readers for taking an interest in the publication and sincerely hope that the hard won experiences and learning that appear in Field Exchange quickly and positively continue to inform your personal practice and agency programming for the benefit of those with whom you work. So here is Field Exchange 50 – Enjoy!
Jeremy Shoham & Marie McGrath Field Exchange Co-editors