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The first activity of Save the Children in Ethiopia goes back as early as 1930. Now this international NGO runs its largest program in Ethiopia in the areas of education and health, among others. The organization has about 1,900 staff and 51 offices across the country.
John Graham, Country Director of Save the Children Ethiopia has been involved in humanitarian work in Ethiopia since 1984. Besides his work with Save the Children, he has traveled extensively throughout Ethiopia and has written several travel articles which he later composed into two books. Capital’s Eskedar Kifle spoke with him about Save the Children’s current operations in Ethiopia and the success and challenges in implementing programs.

Capital: Give us a brief overview of Save the Children’s work in Ethiopia and its current projects.
John Graham:
Save the Children is very large in Ethiopia, it is the largest NGO in terms of size and coverage. We are also the largest Save the Children program in the world. So the organization really sees Ethiopia as the most important program we are doing.
Some of our big programs right now are things like the Newborn Health Initiative; we work very closely with the Ministry of Health on this. All of our work is done with local partners, either with the government which is our preferred partner and also local NGOs.
With the Ministry of Health, we have worked for five years doing research on the best way to reduce newborn mortality. On this, we have worked with the Gates Foundation and with the Lancet magazine which is a famous medical journal.
Based on the research that was done, by mobilizing mothers to use institutional birth, you can reduce infant mortality in the first 28 days by about 30 percent. But then we found out, on top of mobilizing, doing some simple techniques to treat newborns, the mortality rate can be further reduced. Now we have a proven mechanism that reduces infant mortality by 58 percent. We are working with the Ministry of Health on expanding the program to reach the whole country.
In the education sector, we have a program called Literacy Boost. The whole idea is to use some simple techniques, reading materials and other things that can really help children in their early grades to read much better and much quicker.
A few years a go, a review was done on the reading skills of elementary children. And it was found that many of them, even after two years in school, could not read one word in the language of instruction. So there was a pressing need to improve the quality of education that is given. Access to education was needed to increase fast but also the quality needed to get better as well.
Capital: What kind of activities have you carried out to improve the quality of education?
We have been working with schools in many parts of the country  introducing new materials, providing training to teachers, providing resources and do innovative things such as setting up a donkey-drawn carriage library which goes from school to school so the children will get a chance to read something different than their text books.
Through these kinds of interventions we are beginning to see results in terms of the children’s reading abilities.
We also still do a lot of humanitarian work. We used to do 75 percent humanitarian work dealing with emergencies and so on just ten years ago. Now, 75 percent of our work is development work. That reflects the improvements in Ethiopia.
Ethiopia now has more refugees than any other country in Africa; we are working with refugees from Somalia as well as South Sudan. Some of the things we specialize in are making sure children that come through the borders alone are given shelter, food, and a safe place to be as well as work on family reunification.
We also do programs on education in the refugee camps by building schools. We have over 10,000 children in school in the refugee camps in Gambella.
Capital: The number of refugees has been constantly growing and that puts a lot of pressure on resources. What kind of challenges do you face assisting children in the camps?
There are different issues, for example, this past year, the camps in Gambella got completely flooded. We were working in waste water and bringing in medical supplies was challenging. We have a dedicated staff that did their work well and reached those that were isolated and provided basic services such as health and food.
To make sure that the flooding doesn’t happen again, the government is now moving refugees to a safe location and we are assisting with that.
We are also worried that as the food security deteriorates in South Sudan, especially in the area bordering Gambella, we might see a lot more people coming in. It is a war situation on the other side of the border, so we are working on that side as well in order to decrease the reasons for people have to come to Ethiopia.
Capital: You have been operating in the country for a long time.  Are things getting better in the areas you have been working on?
Well, the first time I got involved in Ethiopia was actually during the 1984 famine. I was a graduate student in Canada studying African history and so I was very interested in what was going on here. At that time, Oxfam asked me to raise funds specifically for the areas in the librated zones in Tigray region because they knew the Derg government at the time was preventing food from getting into that area.
So think about now, 30 years later and what it was like in 1984 and 1985, it is an astounding difference. At that time, Save the Children had a big feeding camp in Korem, from where the first international broadcast of the famine was done. In 1984, tens of thousands of children died in the feeding camps around that area because even if they were given enough to be able to survive and were given therapeutic food so that they would recover, they would go back to their families and have nothing to eat again.
So looking at Korem now, we have gone from nothing to eat to now having massive hospitals, we are doing programs now with mother mentors that help young mothers, and we are now able to do sophisticated medical approaches. That is one indicator of how far we have come.
In terms of the health and education systems, in terms of livelihoods, everything has seen so much progress in the country. What I like about the Ethiopian government officials is that even though they recognize all the progress that has been made, they are still determined to make more progress. For example, when we work on education, they say there is a 100 percent access to education in the country, but now we help them improve the quality.
The same goes to health care. There is almost a universal health care but they recognize that new things can be done such as in newborn health. They also know that some remote areas in the country are not getting enough service, so they encourage us to go there.
Capital: Do you implement the education projects in all parts of the region?
I think I can safely say, yes. Our biggest programs are in places like Afar and the Somali region where the education system needs a lot of backing. We give a lot of focus to girls’ education in Afar because of girl’s lower enrollment rates.
Capital: What kind of feedback have you got on those projects?
I met with the head of the education bureau in Tigray a couple of months ago and he was saying that the Literacy Boost was a really good program and he said it needs to be implemented in the whole of the Tigray region. I got similar responses from the other regions as well.
Resource is something we need to have in order to reach more areas. We are happy to have the support from USAID, but even with that we are only going to reach a fraction of the areas. But we are working with the bureau of education in the different regions to expand the program.
Capital: How much funding have you received from USAID and how much more is needed?
We have received about 15 million dollars in the recent grant and it is helping us cover seven language groups. 
Capital: The programes you introduced, were they tried elsewhere and have shown success?
First of all, we start with the government. There is the GTP and we want to support such plans. We have to make sure that what we do fits with what the Ethiopian government wants to do. So we are in constant discussion on what the government needs and most of the ideas are generated from there. We also look at international experiences as we are present in over 70 countries. We have what we call signature programs that we develop an idea we think would work, research it well and spread it out, much like the newborn health and Literacy Boost which are signature programs.
Capital: So what would you say is the biggest challenge children are facing currently in the country?
It depends on how you look at it. The first thing we are concerned with is saving lives; that is the most fundamental thing, you cannot do anything else unless you save the lives. Even though there has been a huge progress on newborn health, we still see very high rate of infant mortality. We still see places where malnutrition gets very bad because of localized droughts and other problems.
Capital: What kind of budget do you have annually and is getting grants more challenging now?
I’m a sales person for Ethiopia and I am trying to get as much resource as possible. We have around 500 million Birr annual budget that is spent directly inside the country. For us, it has not become harder to get funding from our donors. These things go up and down, since the 2008 recession hit, there has been a bit of decline in the overall budget. But a lot of things depend on the way you deliver and your reputation, and whether you are having an impact or not. These are the things donors look at, so for us, we have been continuously growing because we are getting a lot of support, which is a good indicator that we are doing a good job.
Capital: There is a criticism on NGOs that the money doesn’t always go where it should. How do you make sure that is not happening?
We have strong systems of controlling, and because that has been a concern of the government, I don’t think there is any place that has a strict rule and strong administration on NGOs as in Ethiopia.