Friday Podcasts From ECSP and MHI

“I believe that we're experiencing a national reckoning and in this unique moment, I definitely see an opportunity for Congress, but also for our local governments to enact policies that begin to address our country's greatest ills,” said Representative Alma Adams (D-NC-12) at a recent Wilson Center event on women, race, and COVID-19 in the United States. “COVID-19 has revealed what the Black community and communities of color have known for a long time—health outcomes are further compounded by systemic and structural racism. COVID-19 has exposed what women have known for a long time—gender inequality exists, it threatens economic empowerment, and it increases vulnerabilities.” “The pandemic has shown us in the starkest terms how wide the gaps are in health outcomes between Black and White America and between men and women,” said Rep. Adams. Black women, regardless of their educational level or socioeconomic status, are nearly four times more likely to die from preventable pregnancy-related complications than women of other races. “The United States has the highest maternal mortality rate among affluent countries because of the disproportionate death rate of Black mothers,” she said. “Black maternal health in the coronavirus era is truly a crisis within a crisis.” “The pandemic has completely wiped out the historic job gains women have made over the past decade,” said Rep. Adams. Before COVID-19, women made up the majority of the U.S. workforce. They are highly represented in the sectors most impacted by the pandemic. Women are the majority of essential workers, and non-white women are more likely to be doing essential jobs than anybody else, said Rep. Adams. “The work that they do has often been underpaid, undervalued, and an unseen labor force that keeps the country running.” While there has been a positive reduction in women’s unemployment since the pandemic’s onset, most of those impacted are mothers. 41 percent of mothers, and close to 80 percent of Black mothers are the breadwinners for their families, yet continue to face wage inequality. “They're doing the providing, yet they're not getting the income,” she said. “We deserve equal pay for equal work. You know working hard is not enough if you don't make enough.” “We are finding that from the offset of the COVID-19 pandemic there has been an increase in gender-based violence around the world. For every three months of lockdown, there will be an additional 15 million cases of gender-based violence,” said Sarah Barnes, Project Director of the Maternal Health Initiative and Women and Gender Advisor at the Wilson Center. “As a survivor myself of domestic violence, I know firsthand how important it is that we keep working to pass and strengthen legislation to improve services for survivors like the Violence Against Women Act,” said Rep. Adams. “I see a tremendous opportunity for Congress and our society, as well, to pursue transformational structural change because the system isn't working for so many people, especially women and minorities, and it really is time to try to do something else.”

“NCDs have raised the risk of and the severity of the COVID-19 infection,” says Dr. Belén Garijo, Executive Board Member and CEO of Healthcare at Merck KGaA Darmstadt, Germany, in this week’s Friday Podcast. Women living with NCDs like cardiovascular disease, hypertension, cancer, mental health disorders, multiple sclerosis, and diabetes, have an increased risk of severe complications and death from COVID-19. “When you take a look at the mortality rate for one million inhabitants, you see a lot of diversity, and what has been consistent amongst all the countries is the association between severity of the infection and underlying diseases,” says Garijo. “We know that this pandemic is affecting women in a number of ways that are very harsh compared to men,” says Dr. Felicia Knaul, an international health economist and founder of Tómatelo a Pecho. Since the onset of the COVID-19 pandemic, women have experienced “more unemployment, more lack of access to jobs in all but the health sector, more issues of caregiving and less ability to earn income, more exposure to domestic violence.” “In the U.S., women accounted for up to 55 percent of the 20.5 million jobs that have been lost in April. In February, the unemployment rate for adult women was 3.1 [percent], in April this has gone up to 15 percent. In the same period, the unemployment rate for adult men was of 3.6 percent. And in April, this rate, 13 percent,” says Garijo. “The risk that we're facing is that we will see the gains of decades—which were not enough, but were still gains—in gender equality being eroded if we're not careful,” says Knaul. “This pandemic has really changed the way we are looking at our research focus,” says Garijo. “I can tell you that we have, right now, almost completely focused our efforts in finding solutions for pandemics. I am hoping that we will never forget this, and that our pandemic preparedness will stay strong for the future in any and every continent. As an industry, we can never do that alone. We need to collaborate with others. We need to collaborate with governments. We need to collaborate with academic institutions, with healthcare professionals, with patient associations.” “You cannot have strong health systems if you don't include women, not least which, because they are the majority of providers today.” says Knaul. “We've been working on some ideas around how to strengthen health systems in the face of COVID-19 and the first and key lesson is that this cannot be done without a gender transformative response.” A gender transformative response requires the inclusion of all genders, “otherwise we would never be strong enough, not only to respond to the COVID-19 onslaught, but what we're talking about today, which is the incredible onslaught of NCDs that face low- and middle-income populations and countries, as well as, high-income countries.” “I am absolutely sure that you are aware of the articles highlighting that countries that have performed better against COVID-19 are led by women. I have to say that I don't believe this is by chance,” says Garijo. “Female leaders promote the more inclusive leadership model and they are willing to listen. They are willing to listen to diverse opinions and voices. They don't believe they know it all.” This podcast is part of the Maternal Health Initiative’s CODE BLUE series, developed in partnership with EMD Serono, a business of Merck KGaA, Darmstadt, Germany.

COVID-19 has wreaked havoc the world over, and recent data shows that the hardest hit will be the world’s women and girls and populations impacted by racism and discrimination. This week’s Friday Podcast highlights remarks from a recent Wilson Center event sponsored by EMD Serono, the biopharmaceutical business of Merck KGaA, Darmstadt, Germany in the United States and Canada, on the impact of COVID-19 on race and gender inequities. “Mortality of men [due to COVID-19] is higher but let me just emphasize that women play an outsized role in responding not only to COVID-19, but in many of the pandemics,” said Katja Iversen, President and CEO of Women Deliver. “The default health worker is now female,” said Dr. Roopa Dhatt, Founder and Executive Director of Women in Global Health. “Women make up majority of the workforce, but they remain clustered in the lower status, lower paid jobs, mainly the frontline. They also occupy most of invisible lower status jobs as well, so we need to factor in that they're subject to more sexual harassment and violence as a result and are not part of the decision-making table.” “In the midst of this pandemic, bad policies and structural barriers may contribute to millions of people losing access to essential sexual and reproductive health (SRH) services,” said Zara Ahmed, Associate Director for Federal Issues at Guttmacher Institute. To minimize the negative impacts of COVID-19 on SRH services, Ahmed recommends defining and promoting SRH as essential; strengthening supply chains to make SRH medicines more accessible; making contraception available without a prescription; adopting innovative care models of care; and addressing the unique needs of vulnerable and marginalized populations. UNFPA projections show that for every three months of lockdown, there will be an additional 15 million cases of gender-based violence. “In terms of gender-based violence, we're seeing an increase, and this is because of isolation, locked down, restricted movements, tensions in the households from financial and economic stresses,” said Leyla Sharafi, Senior Gender Advisor of UNFPA. Further marginalized groups like women with disabilities, indigenous women, and women and girls living in humanitarian settings have a heightened risk of experiencing violence, said Sharafi. COVID-19 also exacerbates racial inequities. “So, we have three main root causes [of inequities] and those are racism, classism, and gender oppression,” said Dr. Joia Crear-Perry, Founder and President of the National Birth Equity Collaborative. “We do know that black women in the United States, despite income or education, are still more likely to die in childbirth than their white counterparts, so that's really where you see the overarching how those inequities and those beliefs around hierarchy can come together in one space and cause people to die,” said Dr. Crear-Perry. Health care providers are at the center of addressing inequities in the healthcare system, said Dr. Neel Shah, Assistant Professor of Obstetrics, Gynecology, and Reproductive Biology at Harvard Medical School and a practicing OB-GYN in Boston. “One of the challenges that I'm seeing right now is that the biology of this disease and the sociology of this disease really interact, and the people that are historically experts in the biology aren't fully attending to the sociology and honestly, vice-versa,” said Dr. Shah. “Currently we have to isolate people who are both symptomatic and asymptomatic which is effectively everyone. And isolating everyone takes all of the existing inequities in our society and it throws them into a pressure cooker.”

The year 2020 has been designated as the Year of the Nurse and the Midwife by the World Health Organization. In April 2020, the World Health Organization (WHO), International Council of Nurses, and Nursing Now, published the first-ever State of the World’s Nursing Report. This week’s Friday Podcast highlights remarks from a recent Wilson Center event on the report’s findings and recommendations. One of the most exciting things about the report is the evidence on the nursing profession. The data gives nurses the opportunity to find their voices, said Barbara Stilwell, Executive Director of the Nursing Now Campaign. Instead of saying they need more nurses because they feel short of staff, they can present data to decision-makers to show that more nurses are needed on a ward. “You can put it in a graph like Florence Nightingale did and you can take it and show it and make your case for being given more resources,” said Stilwell. “And that’s exactly what’s happening now where we see nurses advocating for more resources to help them deal with the pandemic.” While report findings show that approximately 90 percent of the world’s 28 million nurses are female, they still operate at a disadvantage compared to their male colleagues when it comes to pay equity, hiring, education, and workplace violence and harassment. “The same systems and structures of marginalization or oppression that we see in society such as sexism, racism, patriarchy, we also see these reflected in health systems,” said Rosemary Morgan, Assistant Scientist for the Bloomberg School of Public Health and School of Nursing at Johns Hopkins University. While the vast majority of the nursing workforce are women, men hold most nursing leadership positions. “We must have a gender transformative leadership development program for women in the nursing workforce,” said Leslie Mancuso, CEO and President of Jhpiego. She called for nurses to have equal standing and a level playing field in pay and practice. Nurses, she said, should be treated equally regardless of gender, degree, or wages. One way to ensure that female nurses are adequately represented in nursing leadership is to invest in nursing. The report highlights that we spend 25 percent of the healthcare education budget globally on nurses and midwives who make up 59 percent of the workforce. But that large a shortage may not be acceptable, given what it means for people’s work-life balance, stress, pressure, burnout as well, said Howard Catton, the Chief Executive Officer of International Council of Nurses. WHO is working on investments in the health workforce to address the 6 million shortfall in nurses. The solution involves not only investment for education and training to increase the supply of nurses, but also creating decent, well-paid jobs with good working conditions, said Michelle McIsaac, Economist at WHO and Co-chair of the Global Health Workforce Network Gender Equity Hub. While the data are impressive, so are the gaps in reporting, said Jennifer Breads the Gender Technical Advisor at Jhpiego, particularly around entry-level salaries, educational investments, labor market flows, and gender wage gaps. The COVID-19 pandemic has illuminated the importance of nurses globally. Now more than ever, special attention needs to be focused on nursing. “Nurses remain the heroes we have in tough times that we are in today and they need our support,” said Emily Katarikawe, Country Director of Jhpiego Uganda.

“What are the underlying drivers of risk that created the conditions for Covid-19 to emerge, and how do we better address them?” said Lauren Herzer Risi, Project Director for the Environmental Change and Security Program, in this week’s Friday Podcast, recorded during a recent Wilson Center Ground Truth Briefing on the Covid-19 pandemic. This question framed the discussion, which explored the intersection of the environment, public health, and national security. Although the global pandemic came as a shock to many, the novel coronavirus was not a surprise to epidemiologists and experts who had been sounding the alarm for decades. There have been clear signals of the risks we face from animal-to-human virus transmission, including Ebola, SARS, and other regional epidemics, said Risi. These zoonotic diseases, especially now, are creating concerns about food safety, wildlife conservation, and public health. But the risks don’t just come from wet markets and our increasingly connected world. Drivers of the Outbreak Rapid urbanization and population growth created a ticking time bomb, as we have increasingly intruded into natural habitats. The loss and fragmentation of wildlife ecosystems has brought humans into closer contact with animals than ever before. While the exact origins of coronavirus have yet to be confirmed, we know that this amplified opportunity for virus transmission is a major factor. “An estimated 70 percent of new human infectious disease outbreaks come from pathogens that originated in animals,” said Sharon Guynup, Global Fellow at the Wilson Center and a National Geographic Explorer. We are constantly expanding our interaction with animals and nature. “We need to be very, very clear that this is a human-made problem, a humanity-made problem,” said Dr. Ellen Carlin, Assistant Research Professor at the Center for Global Health Science and Security and Director of the Graduate Program in Global Infectious Disease at Georgetown University. “It’s really all of us collectively making decisions about the way that we live.” Human behavior puts pressure on natural ecosystems through land use and development, mass urbanization, agricultural intensification, extractive industries, and the growing global demand for commodities. Climate change further exacerbates the environmental degradation. Overall this trend is accelerating the emergence of zoonotic diseases in human populations. Another aspect of this close contact between humans and animals is the prevalence of illegal wildlife trade and consumption. Some have called for bans in China, but wildlife trade and wet markets aren’t unique to China, and a solution will require global efforts, said Guynup. It will also be crucial to uphold and enforce the bans put into place, as China’s actions will have a ripple effect on the policies of neighboring consumer and hub countries. For progress to be made, she said, countries must develop multi-pronged approaches, including strengthening policies and enforcement at national levels, raising public awareness, promoting community involvement, and changing consumer behavior. While Covid-19 is much bigger than just a wildlife trade issue, it is a critical piece of the puzzle, said Guynup. National Security Risks The cascading impacts of the pandemic on human health, national economies, and society has elevated the coronavirus as not just a public health crisis, but a national security threat as well. There is currently a disconnect between environmental threats and security paradigms, said Rod Schoonover, founder and CEO of Ecological Futures Group. “Unfortunately, U.S. national security is outdated and needs to be recalibrated, I think, to reflect the threats that the country faces,” he said. Topics like climate change, land use, and biodiversity need to be core national security concerns instead of add-ons to geopolitical goals, said Schoonover, who was Director of Environment and Natural Resources for the Nationa(continued)

What is inherent in the word “universal,” is that it is for all women, said Anneka Knutsson, Chief of the Sexual and Reproductive Health Branch at the United Nations Population Fund (UNFPA), at a recent Wilson Center event on the importance of midwives in achieving universal health coverage. To achieve the ambitious sustainable development goal of universal health coverage, one challenge is to make sure that the women most marginalized aren’t left behind. Elena Ateva, Advocacy Manager at White Ribbon Alliance, said that in order to best support women, we need to ask them what they really need and want. And what women want differs from woman to woman depending on her beliefs, customs, gender identity, sexuality, etc. “We cannot determine policies for somebody else. We need people to be part of those processes,” said Ateva. Midwives can play an important role in representing the needs of a community and reaching women traditional health facilities have often excluded. But, we have to be careful when thinking midwives, alone, are the answer, said Franka Cadée, President of the International Confederation of Midwives. “Midwives are part of a system.” Cadée said that while people are happy to have midwives working with patients, midwives need to also be at the decision-making table, at the ministry, and working with politicians. In the United Kingdom, a midwife serves as a medical officer to advise the Minister of Health on midwifery. To have a midwife in this high-level position allows midwives the opportunity to represent the communities they serve, as well as support the midwifery profession. One way to elevate the status of midwifery and enact concrete change is through midwifery education. Since the early 1990’s, Sweden has created 13 midwifery education programs that go beyond clinical skills. Marie Klingberg-Allvin, Midwife and Professor in Global Sexual and Reproductive Health at Dalarna University said it is important to have strong academic environments which include research. Understanding and contributing to research gives midwives the ability to reflect, to read new science, to be part of developing new standard guidelines in the clinic, and to be vocal and take lead for their own profession, she said. Globally, women make up the vast majority of midwives and gender discrimination plays a role in the limited number of midwives in decision-making positions. To close the gender gap, Klingberg-Allvin said, “you need to have gender-intentional governments to start with” and you also need to have a government that gives status to sexual reproductive health and rights. Cadée said, “Midwives don’t need to be empowered; midwives are very, very powerful. Midwives simply need to be listened to.”

“Women and men face very different risks and challenges,” said Chitra Nagarajan, a writer and journalist who covers climate change, conflict, and gender. She spoke in this week’s podcast about what’s changed in the Lake Chad region. In the last few years the combination of profound climate change and high levels of insecurity have made life harder for the local population. To get a sense of how recent changes have affected Lake Chad’s residents, Nagarajan interviewed more than 250 people. These are some of her findings. “It’s very clear and we know this from other contexts as well,” she said, “that the people who face the most risk and who have been affected the most are those who were already vulnerable and marginalized beforehand or people who acquired vulnerabilities.” As a result, the conflict has impacted men and women differently. Men are much more likely to be viewed with suspicion by all parties to the conflict, more likely to be in detention, more likely to experience extrajudicial killing, and more likely to be recruited by force. Women, on the other hand, face high levels of gender-based violence like sexual abuse and exploitation, forced sex work, increased early marriage, and domestic violence. Despite the harms that women have faced in this conflict, some are newly empowered, taking on roles previously off limits. With men gone, women are heading households and finding ways to sustain families and communities. They wield the decision-making power in their households and communities. “And you really see how women have transformed their own understanding of what they are capable of and also their desires for what they want for their children,” said Nagarajan. This desire to be self-sufficient has in turn increased girls’ education. I want my daughter to have education, to have access to opportunities, so that she will not suffer the way that I have or the way I am, Nagarajan recalled one woman told her. But gender-based violence persists in the region. Due to an underfunded humanitarian response, many gaps exist. In addition, not enough services are provided to change attitudes about stigma and prevent violence. “It is good to provide services to survivors of gender-based violence, but even better than doing that is preventing the violence from taking place in the first place,” she said. “And we have seen very little truly preventative programing on the ground.” Policymakers ignore the impacts of conflict on women’s reproductive health. Women and girls are not able to control their reproduction. And men do not want their wives to have access to contraceptives. “I do think that this is an issue of masculine ego and thinking I am a real man if I have lots of children,” said Nagarajan. Because women and girls who are not married find it hard to access contraceptives, demand for highly unsafe methods to terminate pregnancies has increased. Women wish to end pregnancies for many reasons. They may not be able to take care of so many children. Other reasons include high levels of sexual violence, absence of men, and high levels of victim blaming and stigmatization if the pregnancy is a result of sexual violence. One young woman Nagarajan met was the sole survivor of her family. A soldier forced the woman to have sex in exchange for shelter, then left the area. The young woman relies on the goodwill of neighbors in an informal settlement in Nigeria. When I met her, said Nagarajan, her top priority was to end her pregnancy, because she feared neighbors would stop supporting her due to the extramarital nature of her pregnancy. But she had no access to help to end it. Many people who live around Lake Chad get no support from governments or politicians. “Lack of governance and lack of effective services have been one of the biggest barriers both in terms of being a driver of violence but also in terms of providing services and support to the affected population,” said Nagarajan. (continued)

While there are many uses for global data sets and innovative data analysis technologies, the most important thing, Rodolfo Camacho said in this week’s Water Stories podcast, is not analyzing the data. It’s the collaboration among countries sharing data. Camacho, Project Director at Winrock International and Chief of Party for USAID’s Sustainable Water Partnership (SWP), sat down with Lauren Herzer Risi, Project Director of the Environmental Change & Security Program to discuss the importance of big data and machine learning on improving water security. As the leader of the SWP project, Camacho and his team work to provide technical services and assistance to implement global water security programs. Their work covers all aspects of water security, including water for human consumption, to maintain ecosystems, and for production in the agriculture, energy, and industrial sectors. Another essential part of water security, he said, is to build community resilience to water-related risks such as floods and droughts by increasing access to safe water. In order to develop effective water allocation and distribution plans, the team evaluates the status of water resources. Data and analytics help Camacho’s team understand the amount of surface water and ground water available, trends in the quality of the water, and who is using the water in various quantities. Compensating for Gaps in Data Data can also fill the gaps that are often present in developing countries, said Camacho. He noted that data collection can pose a challenge in places where both data and gauging stations are scarce, inconsistent, and unreliable. When actual data is not available, AI technology and machine learning enables Camacho’s team to run models and extrapolate estimates. For example, Camacho described an aspect of SWP’s water allocation project in Kenya and Tanzania. “We have sections in Tanzania in the Mara River,” he said, “where there are no gauging stations.” Therefore, there are no records. Once we understand the water flows by analyzing the data, Camacho said, we can use what we have to calibrate models to establish rainfall patterns. The team can then use modeled quantities and develop better plans for water allocation. Camacho described how data could be used in water allocation and planning. To develop a water allocation plan for the Mara River Basin (Kenya/Tanzania), Camacho and his team must factor in not only how much water is available, but also how much of that is being channeled to population, agriculture, and domestic usages. The Partnership applies data collection and analytics to come up with water planning systems that also take the surrounding ecosystem’s needs into consideration. In the Tonle Sap Basin (Cambodia), the project focused on communities’ access to clean water. Water data and analytics are used to understand water quality and reliability. In nearby agricultural areas, pesticides and other contaminants get into the water supplies. This has a huge impact on the communities that rely on the river for fisheries. “We are not using best practices and that has an effect downstream,” said Camacho. As a result, you get fish die off or contaminated water that cannot be used. Because data is viewed as an important asset to international development and increased water security, a concerted effort has been made to standardize data formats and make global data sets more widely available. New tools are being developed to increase water security and sustainability. Data visualization and forecasting allow information on essential water variables and patterns to be accessed worldwide and then used for disaster and emergency preparedness. Camacho pointed out that these new advances will be useful tools for developing nations where big data is harder to collect. The most significant feature of emerging data technologies, according to Camacho, is these tools’ ability to transcend boundaries and borders and enable cooperat(continued)

“This project is serious,” Casimiro Olvida said. “It will help the community. If you do not believe me, you can kill me anytime.” He recalled saying this in 1995 to Communist rebels in Mindanao who were suspicious that his USAID-funded team was supporting the Philippine government. We have the same goals, he told them, to help the poor and protect the environment. Apparently, he was convincing. Now Watershed Protection Project Manager of the Sarangani Energy Corporation, Olvida spoke in this week’s podcast with ECSP’s Lauren Risi, at the International Conference on Environmental Peacebuilding in October 2019, describing his decades of work in forest management in the Philippines. As Senior Natural Resources Management Consultant of the USAID-funded Philippine Environmental Governance Project (EcoGov), also known as "From Arms to Farms,” Olvida aimed to deliver tangible livelihood assistance to former combatants and their families. Another main goal, he said, was to ensure adherence to the provisions of the 1996 peace agreement of the Philippine government and Moro Islamic Liberation Front (MILF) leaders to prevent further armed struggle. The work could be scary, Olvida said. The MILF had not yet been in negotiations with the government, and facilitating those discussions proved to be challenging. He received death threats and was pressured to expedite the process, but he refused to take shortcuts. For the former combatants, the choice was simple, said Olvida. They could either follow the rules agreed upon by EcoGov and the MILF leaders, or they could take it up with their commanders. Given the choice, they always ultimately agreed to play by the rules. This progress made the work rewarding, despite the potential dangers. Olvida’s efforts focused on integrating community-based approaches to forest management with local governments and engaging all actors in the space—including government officials, the indigenous community, and former MILF combatants. Much of his work required him to immerse himself in the culture of the communities affected by the armed conflict in Mindanao. He stayed in the villages with key leaders to learn more about the indigenous knowledge, systems, and practices for forest management. The first step to community organizing is to immerse yourself, Olvida said of his 16-year stint getting to know the culture, leadership, and influencers of the community from the inside. By rejecting his privilege and choosing not to stay in a hotel, he was far more successful embedding himself and his project into the community. He was able to build trust and work effectively as part of the community to develop solutions for managing the natural resources in the area. On the other side of EcoGov’s project, the community-based approaches and development goals needed to be absorbed into the policies and procedures of local government. For Mindanao, this process was largely successful with the creation of convergence initiatives, which enabled government agencies to work together on this issue area. Olvida cited governance as “the missing link” for implementation. However, he acknowledged that it’s difficult to make progress on a project when funding stops. When newly appointed local government personnel lack forest management experience, they return to the old ways. Without consistent funding and an implementation system set in place, Olvida said, a forest management project cannot be sustainable.

Through open source information, remote sensing, and existing data, we can have a better sense of how conflict impacts the environment and how it then impacts people depending on the environment, said Wim Zwijnenburg, a Humanitarian Disarmament Project Leader for the Dutch peace organization, PAX, in this week’s Friday Podcast. Wim sat down for an interview with ECSP’s Amanda King at the first International Conference on Environmental Peacebuilding, hosted at the University of California, Irvine, in October 2019. Data Visualization for Advocacy PAX works to improve data visualization, especially information about what’s happening on the ground in conflicts. Drawing on everything from social media and existing models, to satellite imagery from remote sensing platforms, they identify hotspots, see if environmental infrastructure has been hit, and monitor specific incidents. “Eventually,” he said, “we want to show that you can do way more and you can improve the conflict analysis and monitoring with existing means.” One of the most successful examples where data influenced policy was in Iraq. In 2014, the Islamic State took over the large parts of Northern Iraq. It used the environment as a weapon by setting fire to oil wells and sulfur stocks, resulting in release of a plume of SO2 in the air, the hospitalization of 1,000 people, and death of a dozen people. At the same time, they damaged water infrastructure, reducing access to clean water and usable land. Together with the Iraqi Ministry of Environment we published our report showing what was happening in Iraq in terms of environmental pollution and what needs to be done, Zwijnenburg said. Information we’ve been collecting since 2014 helped to advocate for a strong UN resolution to speed up the process for post-conflict environmental assessment, he said, and hopefully save them time and money. Modern Weapons Target Environmental Infrastructure Modern warfare and new weapons are changing military tactics. In Yemen, the Houthis have developed a drone system that can hit targets more than 1,000 kilometers away. Over the last year, in response to daily bombings, the Houthis targeted airports, water filtration stations, and oil facilities in Saudi Arabia. And in September 2019, 25 drones and missiles, likely from Iran, hit the biggest oil processing plant in the world in Saudi Arabia. Given newer weapons’ capabilities, targeting environmental infrastructure has become a way for states and armed groups to pressure others. Zwijnenburg painted a bleak picture of the future, describing a world that must contend with modern warfare and technologies’ long-term environmental consequences, increasing tensions over access to natural resources, and more gruesome technology for attacking others. However, he noted that innovative technologies can help us see the impacts of conflict and may also help us more quickly respond to environmental issues. Since using technologies in new ways gives us more insight into what is happening in conflicts, we can respond faster and hold perpetrators more accountable. What’s more, the ability to visualize the impacts of conflict can also help raise awareness of the links between environmental damage and conflict. “It is empowering communities because people have the ability and the tools to understand what is happening around them,” said Zwijnenburg, “and that information is useful for policy work and political pressure.”

“I believe if you acknowledge women as primary users of environmental resources, if you draft the policy with women [at] the table, offering you their unique perspective and unique feedback, you’re going to have a more stable policy. A policy that gets implemented,” says Mishkat Al-Moumin, scholar in residence at the Environmental Law Institute, in this week’s Friday Podcast, and second in a series of interviews recorded at the First International Conference on Environmental Peacebuilding. Al-Moumin served as Iraq’s first Minister of Environment in the Iraqi Interim Government in 2004. She had previously served as one of the first female professors at Baghdad University’s College of Law. “That might sound like kind of an easy summary. But in reality, being accepted at the law school was really not that easy,” she says. Navigating personal and professional challenges as both a woman and a single mother in Iraq led Al-Moumin to understand the importance of recognizing the linkages between women and the environment. While she ran the Ministry of Environment with a budget of just 7 million dollars, Al-Moumin continued advocating for women’s inclusion and participation. “The ministry had the second lowest budget throughout the cabinet,” she says. And they were tackling massive environmental challenges, from the extreme degradation of marshlands to the pollution from years of war. Juggling these issues taught Al-Moumin about conflict in a very personal way. In 2004, she survived an attack on her life, in which four of her personal bodyguards were killed. Shortly thereafter, she applied and was accepted to Harvard University’s Kennedy School, where she was able to examine her on-the-ground experiences through a broader lens. Her research continues to focus on the conflict-environment-law nexus, with a particular focus on the Middle Eastern context. “If environmental policies are designed in a way that deprives certain people from access to an environmental resource, then a conflict will arise,” says Al-Moumin. In Iraq, conflicts are viewed as having either a religious or ethnic lens. The environmental dimension is generally ignored, she says. This is compounded by the fact that most Middle Eastern policy prohibits certain actions without accounting for how particular resources will be managed. In Iraq, for example, timber is prohibited from being cut down without a legal framework for sustainable harvesting. This causes a struggle for everyday citizens, as they are likely to be shut out of certain resources. Women are particularly impacted, as the laws are written by men and tend to ignore women’s roles in natural resource use and collection. In general, Al-Moumin says, Middle Eastern policy tends to look to history for answers to present-day challenges. Laws from the Ottoman Empire still persist, she says. But meeting the challenges of tomorrow requires forward thinking—and greater empowerment of every citizen, regardless of gender. “It’s the government’s job to solicit people’s opinions and open up venues for them to participate. Otherwise, you know,” says Al-Moumin, “that disconnect will continue forever and violence will be the answer [every] time we have a problem.”

The United States and China are on the road to war, said Senior Advisor of New America’s Resource Security Program, Sharon Burke in this week’s Friday Podcast. “And if you’re an environmental peacebuilder and you’re not thinking about that, you might want to,” she added. She spoke with Geoffrey Dabelko, Professor at Ohio University and Senior Advisor to ECSP, at the first ever International Conference on Environmental Peacebuilding in October 2019 at the University of California, Irvine. It’s a war we can’t afford, said Burke. “But we’re not doing anything to avoid it at the moment, in my opinion, other than deterrence.” In a primarily adversarial relationship, said Burke, does environmental peacebuilding have the ability to be a bright spot on an otherwise bleak path toward a seemingly inevitable war? According to Burke, the role of natural resources has become relevant to strategic investments and security in two main ways. First, resources are already a part of the competition, and will increasingly shape the struggle for both material resources and geopolitical influence. The effects of climate change on resource availability will also drive the priorities of both China and the United States as the two largest economies in the world. A key difference, Burke points out, is size. The United States has a population of 330 million people, compared to China’s population of 1.4 billion. Another difference relates to how the countries are trying to address resource gaps related to climate change. China has begun diversifying resource suppliers and taking into account the strain climate change will put on the global supply chain, especially in the agricultural and critical minerals sectors. On the other hand, the United States puts greater trust in the markets and lacks a natural security strategy. Dabelko compared the current situation with China to the environmental peacebuilding efforts between the United States and Soviet Union during and after the Cold War. The U.S. military engaged with other militaries globally during this period using environmental and scientific exchanges as a means to open a dialogue and reach a secure end. In recent years, there have not even been attempts at these types of exchanges with an environmental component. Burke believes that it’s still worth a try. “[The environment is] certainly going to be a point of contention going forward,” said Burke. “So why can’t it also be a point of collaboration?” Burke and Dabelko wrapped up the conversation by imagining a possible future marked by a changing climate. Burke hypothesized that as climate change affects global agriculture, we will need trade to adjust and adapt to the changing patterns of food production. Burke noted that that our planet does have the capacity to grow enough food even as the population grows, but the areas where food is grown will need to shift as the climate changes. In order to thrive, we will need to become more flexible with trade and stay away from locking in strictly bilateral deals. Climate change may create a powerful need for global collaboration and cooperation, Burke concluded. This interview was recorded at the first International Conference on Environmental Peacebuilding, hosted by the Environmental Law Institute, Duke University, University of California, Irvine, and the Blum Center for Poverty Alleviation in October 2019.

“For me, [multiple sclerosis (MS)] presented itself shortly after the birth of my second son. I had these symptoms; I had this profound fatigue that I didn’t have with my first child,” said Terrie Livingston at a recent Wilson Center event about the growing threat of non-communicable diseases (NCDs) on maternal health. Livingston is the Head of Patient Outcomes and Solutions at EMD Serono, a business of Merck KGaA, Darmstadt, Germany. “MS primarily affects women, with the average age of diagnosis at about 33 years of age…when women are really thinking about having a family,” said Livingston. Livingston didn’t associate her symptoms with MS initially, and assumed they were due to either her recent pregnancy or the demands of caring for a newborn. Pregnancy is an immunotolerant state, in which the immune system is able to tolerate a foreign substance, i.e. placenta and fetus. Due to changes in hormones, there are fewer relapses in MS patients who are pregnant, said Livingston. There is, however, a significant increase in the number and severity of relapses postpartum, she said. Symptoms of MS can be mistaken for other common symptoms of pregnancy, complicating diagnosis. In fact, it was about two years between the symptoms presenting and Livingston actually receiving the diagnosis of MS. Misconceptions about the disease adversely impact a woman’s perception of her ability to become pregnant. Livingston recalled a time when physicians discouraged women with MS from having a family, telling them that it wouldn’t be possible. In fact, the U.S. has seen an increase in the prevalence of pregnancies in MS patients. It’s important to raise awareness around race, disparities, and social determinants of health when it comes to MS and other non-communicable diseases, said Livingston. “Just like the changing face of the U.S., MS is also changing,” she said. What was once thought of as a disease that primarily affected Caucasian women, MS is now most prevalent in African American women. As an Asian American, Livingston attributes some of her delayed diagnosis to the fact that she’s “not the typical MS patient.” Also lacking is an awareness of the links between MS and other chronic illnesses —like hypothyroidism, inflammatory diseases, hypertension, diabetes, and mood disorders. 40 to 60 percent of MS patients have mood disorders that include anxiety and depression. The heightened risk of other chronic co-morbidities is why it is important for individuals with MS to plan ahead when it comes to pregnancy, said Livingston. Pregnant women with MS need integrated care plans that are tailored to their needs based on where they are in their journey. Since Livingston was diagnosed in 2006, the number of Disease-Modifying Therapies (DMTs) available for MS has increased from 4 to 17. “If you think about from 2006 to now, that’s 1 DMT that was approved every single year over the 13 and a half years,” she said. This gives providers and patients more options for treatment, but importantly, Livingston said, “it also gives patients hope.” There is a “big opportunity” to provide education to patients with MS, and we need to continue addressing those unanswered tough questions, said Livingston. In her role as an MS patient advocate she is uniquely placed to drive research efforts and tackle topics around co-morbidities, symptom management, race, ethnicity, and healthcare disparities. “Living with MS, it has allowed me to impact people in a way that I could have never imagined,” said Livingston.

To address the security challenges facing Sub-Saharan Africa we need to shift the focus from a concept of state security to one of citizen security, says Ambassador Phillip Carter III (ret.), former Ambassador to the Ivory Coast and the Republic of Guinea, in this week’s Friday Podcast. “Our current strategy of a military response to terrorist organizations or criminal networks is inadequate at best, and probably unsustainable at worst,” says Carter. “To me, the greatest security threat in Africa is poor or bad governance.” If you ask Africans what they perceive as threats to their security, terrorism isn’t at the top of their list, says Carter. “It’s dealing with corruption, it’s dealing with criminality, it’s making sure that their daughter can go to school without being assaulted, that their son can go to work without paying a bribe to a police officer.” Foreign policy has long operated in the realm of “state security”—investing in government institutions, militaries, and Ministries of Defense to promote security. “That needs to be challenged,” says Carter. “We find that many militaries are there to protect the regime, not necessarily the population.” In addition to the military interventions focused on countering violent extremist organizations, “we need to look at the softer side of things,” says Carter. “Investing in issues like girls’ education, addressing the issue of gender inequality—these development objectives are actually security objectives. We know that high levels of gender inequality foster violence and we know that investing in girls’ education results in manifold increases with regard to GDP growth and prosperity that is inclusive. We know that when you empower women in a society, you are improving the sustainability of growth, of prosperity, of economic activity, and security.” Supporting local institutions is critical to strengthening governance, says Carter, and a large part of that is ensuring that local organizations have the data and information to understand what their constituencies need. “I believe that good governance and democracy are social vaccines for a lot of things, but we have to engage in institutions that organizationally represent those values—they’re representative, they’re democratic in their structures, they’re inclusive, and they’re data driven,” said Carter. “If the assistance is driven out of Washington rather than out of the local community, it’s not going to be as effective as it could be.”

“If you live in the developed world or in some urban centers, then the supply of water is guaranteed,” said Gordon Mumbo, team leader for Sustainable Water for the Mara River Basin, a project of Winrock International and USAID’s Sustainable Water Partnership, in this week’s Water Stories podcast. When you wake up, you expect water to flow from your tap. “If you don’t find it flowing, you get upset and will probably call the utility company.” But people living in the Mara River Basin don’t have that luxury. “They have to walk to the river to get water and bring it home,” said Mumbo. With the Sustainable Water Partnership project, Mumbo is working to make sure the Mara River keeps flowing and meets the demand for water. A cornerstone of the project is determining how much water is available and how much water the basin needs. Mumbo and his colleagues are working across Kenya and Tanzania on a water location plan that considers how much water is needed to sustain the environment, the people, and the wildlife, said Mumbo. Once they are able to identify the gaps between supply and demand, they will be better positioned to manage the river. The project is also working to preserve the watershed by creating livelihoods that don’t require cutting trees and other vegetation. With a high demand for honey in the region, beekeeping has been one of their successful alternative livelihoods. “One would not want to cut down a tree where a beehive is kept,” said Mumbo. When the Mara River Basin project started, there was no adequate platform for private investment, said Mumbo. He and his colleagues helped the private sector organize to invest in water management. For example, they registered a Mara Basin hoteliers association to facilitate their investment in water management to maintain the ecotourism industry. The hoteliers understand that the health of their business depends on the health of the Mara. The government, meanwhile, needs to create an enabling environment that can attract investment from private investors. This involves creating a friendly policy environment, regulatory systems, access to financing, and sharing water information with the private sector and the general public. When asked what the greatest lesson from the Sustainable Water Project has been, Mumbo said that gaining the public participation of stakeholders in water conservation was key. You must be able to share the data freely with stakeholders for them to understand how much water is available and when certain policies—like water managers sometimes asking farmers to stop irrigating—are necessary. This understanding and rapport is vital for the future as a rising population and a changing climate will only make the need for effective water management in the Mara River Basin greater.