Friday Podcasts From ECSP and MHI

Maps help us to grasp complex ideas, such as patterns of risk and vulnerability, but the stories they tell can have significant implications. “It’s very difficult to validate that what you’re capturing in the maps is representative of real-world phenomenon,” says Joshua Busby in this week’s “Backdraft” episode, describing his efforts to map climate and security hotspots in Africa and Asia. “You have to be modest in what you think the maps can tell policymakers, but also realize there is some seductive power in the way maps simplify complex reality.” The maps produced by Busby’s Climate Change and African Political Stability and Complex Emergencies and Political Stability projects are designed to help planners, donors, and national governments “shore up resilience on the ground.” “The real question that we have to ask and answer all the time is, ‘Do the maps have any basis in reality? Are they useful?’ ” says Busby, associate professor from the LBJ School at the University of Texas, Austin. When Busby and his team traveled to East Africa, they found that some of the challenges associated with chronic water scarcity were missing from their work, so they incorporated new indicators and updated the maps to more accurately represent the current situation. Without this “groundtruthing,” the maps could be misinterpreted and used to support interventions and other policy actions that could produce negative results, such as conflict. Building Consensus on Climate Action With proper groundtruthing, maps can be useful tools for reaching new audiences—and for reaching across the aisle. To build political consensus on climate change in the United States, Busby suggests focusing on related challenges, like water’s connection to security. “Because of its centrality to human wellbeing, [water] creates a reservoir of political goodwill that goes across political ideologies, and that’s why we’ve had great success in the U.S. government in creating a groundswell of sustained support for water and sanitation projects.” However, a focus on water is not a silver bullet, especially if that focus is primarily on providing infrastructure, or “taps and toilets,” without supporting the governance mechanisms needed to manage resources sustainably. “What’s been lost in this wider discussion are concerns about water and security and the institutions both at the national and international [level] that can shore up the ability of countries to manage water resources on their own,” says Busby. Donors should support efforts to build the capacity of countries to sustainably manage their water resources, particularly resources that are shared with other countries. As climate change increases both floods and droughts, poorly managed water resources could spur political instability both within and between countries.

“How do we present things in a responsible way?” asks Dr. Doris Chou of the World Health Organization (WHO) during a Wilson Center panel discussion on “Maternal and Women’s Health, Two Years In: Measuring Progress Towards Meeting the SDGs.” “My job is to make sure things don’t get misinterpreted,” says Chou. WHO’s Ending Preventable Maternal Mortality (EPMM) strategy, which was published in 2015, informed the Sustainable Development Goals’ (SDGs) indicator index for maternal health. Chou explains that the EPMM’s themes “speak to empowering women and girls, ensuring country engagement and leadership, and…improving metrics and measurement.” To ensure accuracy, we need to use have clear shared definitions of maternal health terminology. “What do we mean by maternal death?” Chou asks. “There is a definition, but the interpretation of that definition, we found in the MDG monitoring, varied widely.” Miscommunication and misunderstanding between English and Spanish definitions of the term led to “three years of political discussion—on one word,” she explains. Accuracy also requires seeking input from the most important people: the women and adolescents who are at the center of the data. “Can we make sure that everybody who needs to be at the table is at the table to think this through? For instance…when we talk about measuring essential adolescent services, what is essential? ‘Essential’ to you and me might be very different than ‘essential’ to the adolescent that we are trying to reach,” says Chou. “We have to take stock of the old, while we are moving forward and trying to look really far in the future so that we can really always make sure that things are harmonized,” Chou explains, but sometimes it is necessary to stop and understand why we are doing what we are doing. “We are really in a fantastic time that we can really think about this and make a change,” says Chou. “Everyone, everywhere, has something to do.”

“How do we present things in a responsible way?” asks Dr. Doris Chou of the World Health Organization (WHO) during a Wilson Center panel discussion on “Maternal and Women’s Health, Two Years In: Measuring Progress Towards Meeting the SDGs.” “My job is to make sure things don’t get misinterpreted,” says Chou. WHO’s Ending Preventable Maternal Mortality (EPMM) strategy, which was published in 2015, informed the Sustainable Development Goals’ (SDGs) indicator index for maternal health. Chou explains that the EPMM’s themes “speak to empowering women and girls, ensuring country engagement and leadership, and…improving metrics and measurement.” To ensure accuracy, we need to use have clear shared definitions of maternal health terminology. “What do we mean by maternal death?” Chou asks. “There is a definition, but the interpretation of that definition, we found in the MDG monitoring, varied widely.” Miscommunication and misunderstanding between English and Spanish definitions of the term led to “three years of political discussion—on one word,” she explains. Accuracy also requires seeking input from the most important people: the women and adolescents who are at the center of the data. “Can we make sure that everybody who needs to be at the table is at the table to think this through? For instance…when we talk about measuring essential adolescent services, what is essential? ‘Essential’ to you and me might be very different than ‘essential’ to the adolescent that we are trying to reach,” says Chou. “We have to take stock of the old, while we are moving forward and trying to look really far in the future so that we can really always make sure that things are harmonized,” Chou explains, but sometimes it is necessary to stop and understand why we are doing what we are doing. “We are really in a fantastic time that we can really think about this and make a change,” says Chou. “Everyone, everywhere, has something to do.”

In this podcast postscript, Simon Nicholson goes into detail about the array of climate engineering technologies being researched.

In this podcast postscript, Simon Nicholson goes into detail about the array of climate engineering technologies being researched.

When the Paris Agreement set an ambitious goal of limiting the global temperature rise to 1.5 degrees Celsius above pre-industrial levels, the negotiators put climate engineering on the table, says Simon Nicholson, professor at American University in this week’s episode of Backdraft. Once the purview of science fiction, a majority of the models run by the Intergovernmental Panel on Climate Change (IPCC) required large-scale use of climate engineering technologies to keep additional warming below 2 degrees. “Nobody who was arguing for that 1.5 degree target at Paris was thinking in their heads we should start shooting sulfate particles into the atmosphere,” says Nicholson. They were looking at the science and recognizing that without aggressive action a lot of people will suffer. But, says Nicholson, it’s not clear that the target is attainable through traditional mitigation alone. “The entire conversation is in some ways an unintended consequence of not doing enough. Very few people want to talk about doing climate engineering. The reason you get a growing number of scientists and policymakers [discussing climate engineering], is because the situation is getting pretty desperate.” There are two types of climate engineering technologies – solar radiation management and carbon dioxide removal. While carbon dioxide removal tends to be slow-acting and expensive, solar radiation management is fast-acting and seemingly cheap. “One thing to really pay attention to is that each of the technologies has its own risk profile,” says Nicholson, the co-founder of the Forum for Climate Engineering Assessment. “We have to parse them out and discuss them one by one.” Both technologies have significant environmental, political and social, and existential implications. For example, bio-energy with carbon capture and storage (BECCS), a carbon dioxide removal technology used in the IPCC modeling, would require an immense industrial infrastructure to capture carbon and move it to storage. There would be massive changes in land use, which could generate political and social conflicts. Determining who gets a voice in the decision-making process will be extremely complicated and could increase the vulnerability of already vulnerable communities, says Nicholson. While faster-acting and less expensive than carbon removal technologies like BECCS, solar radiation management technologies, like stratospheric aerosol injection, could have devastating environmental consequences. “Even if we get it right, there is potential for downsides,” says Nicholson. “The biggest problem is the social and political transformation that’s needed so that long-term human beings and the way that we live are compatible with ecological realities,” says Nicholson. “Solar radiation is not a fix… And yet, one could imagine politicians and other actors try to sell it as a fix.” Currently, there is no formal governance system overseeing climate engineering, and Nicholson suggests that this may be an even bigger hurdle than even the environmental impacts. A successful climate intervention would require at least a couple hundred years to achieve a significant decrease in temperature, and stopping an intervention prematurely could lead to a spike in warming. “How do you build a system of governance that lasts across multiple centuries?” he asks. “It might not be the technological challenges that sink something like stratospheric aerosol injection; it may be that the political conversation is just too tough. We just can’t find a way to put together a governance arrangement that’s robust enough that the world community buys it.” “Although negotiators didn’t intend for this to be the case, now we’re kind of locked into a conversation where climate engineering is on the table,” says Nicholson. “If these [technologies] do start to come onto the table, then they can’t be used as cover for inaction. And that is perhaps the biggest political challenge in this space.”

When the Paris Agreement set an ambitious goal of limiting the global temperature rise to 1.5 degrees Celsius above pre-industrial levels, the negotiators put climate engineering on the table, says Simon Nicholson, professor at American University in this week’s episode of Backdraft. Once the purview of science fiction, a majority of the models run by the Intergovernmental Panel on Climate Change (IPCC) required large-scale use of climate engineering technologies to keep additional warming below 2 degrees. “Nobody who was arguing for that 1.5 degree target at Paris was thinking in their heads we should start shooting sulfate particles into the atmosphere,” says Nicholson. They were looking at the science and recognizing that without aggressive action a lot of people will suffer. But, says Nicholson, it’s not clear that the target is attainable through traditional mitigation alone. “The entire conversation is in some ways an unintended consequence of not doing enough. Very few people want to talk about doing climate engineering. The reason you get a growing number of scientists and policymakers [discussing climate engineering], is because the situation is getting pretty desperate.” There are two types of climate engineering technologies – solar radiation management and carbon dioxide removal. While carbon dioxide removal tends to be slow-acting and expensive, solar radiation management is fast-acting and seemingly cheap. “One thing to really pay attention to is that each of the technologies has its own risk profile,” says Nicholson, the co-founder of the Forum for Climate Engineering Assessment. “We have to parse them out and discuss them one by one.” Both technologies have significant environmental, political and social, and existential implications. For example, bio-energy with carbon capture and storage (BECCS), a carbon dioxide removal technology used in the IPCC modeling, would require an immense industrial infrastructure to capture carbon and move it to storage. There would be massive changes in land use, which could generate political and social conflicts. Determining who gets a voice in the decision-making process will be extremely complicated and could increase the vulnerability of already vulnerable communities, says Nicholson. While faster-acting and less expensive than carbon removal technologies like BECCS, solar radiation management technologies, like stratospheric aerosol injection, could have devastating environmental consequences. “Even if we get it right, there is potential for downsides,” says Nicholson. “The biggest problem is the social and political transformation that’s needed so that long-term human beings and the way that we live are compatible with ecological realities,” says Nicholson. “Solar radiation is not a fix… And yet, one could imagine politicians and other actors try to sell it as a fix.” Currently, there is no formal governance system overseeing climate engineering, and Nicholson suggests that this may be an even bigger hurdle than even the environmental impacts. A successful climate intervention would require at least a couple hundred years to achieve a significant decrease in temperature, and stopping an intervention prematurely could lead to a spike in warming. “How do you build a system of governance that lasts across multiple centuries?” he asks. “It might not be the technological challenges that sink something like stratospheric aerosol injection; it may be that the political conversation is just too tough. We just can’t find a way to put together a governance arrangement that’s robust enough that the world community buys it.” “Although negotiators didn’t intend for this to be the case, now we’re kind of locked into a conversation where climate engineering is on the table,” says Nicholson. “If these [technologies] do start to come onto the table, then they can’t be used as cover for inaction. And that is perhaps the biggest political challenge in this space.”

“Water scarcity is a nightmare scenario that is all too real and all but inevitable in Pakistan,” says Michael Kugelman, deputy director of the Wilson Center’s Asia Program, in this week’s podcast. Pakistan faces the intersecting challenges of population growth, inefficient infrastructure and policies, deep societal inequality, and climate change, leading to a situation where the country is “voraciously consuming water even as water tables are plummeting precipitously,” says Kugelman. Not only are water problems exacerbating internal tensions, they’re complicating relations with fellow riparian and upstream rival, India. The degree of Pakistan’s dilemma is profound. A 2015 International Monetary Fund report found that Pakistan’s water consumption is the fourth highest in the world and its water intensity rate (the amount of water needed for every unit of GDP) is also among the highest. Groundwater reserves, the “last resort of water security,” says Kugelman, is a “safety net that is fraying.” He cites a NASA study that found the Indus Basin aquifer, shared between India and Pakistan, is the second most overdrawn in the world. High levels of consumption are driven by the “robust demand of a rapidly growing population, which now numbers close to 200 million people,” says Kugelman. The annual growth rate is around 1.8 percent, and is projected to stay above 1 percent until at least 2030. Poor infrastructure and policy also contribute to the dilemma. “Pakistan is unfortunately rather notorious for its leaky, dilapidated pipes, canals, and dams,” says Kugelman, which in turn supply a huge agricultural sector that guzzles water at an enormous rate. The government subsidizes water-intensive crops, like sugar, while encouraging inefficient irrigation methods, like flood irrigation. Overall, agriculture may account for 90 percent of Pakistan’s water usage, says Kugelman. In “feudal-like conditions” of deep inequality, tenants struggle to access water on land controlled by elites, who face little scrutiny in how they use it. “It’s been said that land ownership is as a proxy for water rights,” says Kugelman. “If you don’t own land, your right to water is highly tenuous.” While these factors drive up demand, climate change is imperiling supply. The glaciers of the Western Himalayas, the headwaters of the Indus River and its tributaries, have been melting rapidly. “The government in Pakistan has claimed that glacial melt on Pakistan’s mountains has increased by nearly 25 percent in recent years,” says Kugelman. “The once mighty Indus River has slowed to essentially a trickle in parts of the southern province of Sindh.” Many in Pakistan, including anti-India terror groups, see these problems and accuse India of hoarding water and depleting rivers that flow across the border. Some believe the only solution is to “liberate” the disputed border areas of Jammu and Kashmir. But Kugelman says there is no evidence to support this accusation and that India is “more of a convenient scapegoat than a genuine explanation.” India has mostly built “run of the river” dams that do not store appreciable amounts of water and thus do not keep water from flowing across the border, he says. The Indus Waters Treaty also gives Pakistan the rights to the three largest rivers of the basin, amounting to 80 percent of flows, says Kugelman. “The broader reality is that there has actually been a fair level of cooperation between these two enemies in managing transboundary water resources in the Indus Basin.” Climate change and rapid population growth are changing conditions significantly and there have been calls on both sides for the treaty to be renegotiated, but Kugelman believes there is not enough trust between the two for a renegotiation to be productive at the moment. “It is 100 percent wrong to claim that water is a soft issue, that the two sides can use water as a confidence building measure,” he asserts. Resolu(continued)

“Water scarcity is a nightmare scenario that is all too real and all but inevitable in Pakistan,” says Michael Kugelman, deputy director of the Wilson Center’s Asia Program, in this week’s podcast. Pakistan faces the intersecting challenges of population growth, inefficient infrastructure and policies, deep societal inequality, and climate change, leading to a situation where the country is “voraciously consuming water even as water tables are plummeting precipitously,” says Kugelman. Not only are water problems exacerbating internal tensions, they’re complicating relations with fellow riparian and upstream rival, India. The degree of Pakistan’s dilemma is profound. A 2015 International Monetary Fund report found that Pakistan’s water consumption is the fourth highest in the world and its water intensity rate (the amount of water needed for every unit of GDP) is also among the highest. Groundwater reserves, the “last resort of water security,” says Kugelman, is a “safety net that is fraying.” He cites a NASA study that found the Indus Basin aquifer, shared between India and Pakistan, is the second most overdrawn in the world. High levels of consumption are driven by the “robust demand of a rapidly growing population, which now numbers close to 200 million people,” says Kugelman. The annual growth rate is around 1.8 percent, and is projected to stay above 1 percent until at least 2030. Poor infrastructure and policy also contribute to the dilemma. “Pakistan is unfortunately rather notorious for its leaky, dilapidated pipes, canals, and dams,” says Kugelman, which in turn supply a huge agricultural sector that guzzles water at an enormous rate. The government subsidizes water-intensive crops, like sugar, while encouraging inefficient irrigation methods, like flood irrigation. Overall, agriculture may account for 90 percent of Pakistan’s water usage, says Kugelman. In “feudal-like conditions” of deep inequality, tenants struggle to access water on land controlled by elites, who face little scrutiny in how they use it. “It’s been said that land ownership is as a proxy for water rights,” says Kugelman. “If you don’t own land, your right to water is highly tenuous.” While these factors drive up demand, climate change is imperiling supply. The glaciers of the Western Himalayas, the headwaters of the Indus River and its tributaries, have been melting rapidly. “The government in Pakistan has claimed that glacial melt on Pakistan’s mountains has increased by nearly 25 percent in recent years,” says Kugelman. “The once mighty Indus River has slowed to essentially a trickle in parts of the southern province of Sindh.” Many in Pakistan, including anti-India terror groups, see these problems and accuse India of hoarding water and depleting rivers that flow across the border. Some believe the only solution is to “liberate” the disputed border areas of Jammu and Kashmir. But Kugelman says there is no evidence to support this accusation and that India is “more of a convenient scapegoat than a genuine explanation.” India has mostly built “run of the river” dams that do not store appreciable amounts of water and thus do not keep water from flowing across the border, he says. The Indus Waters Treaty also gives Pakistan the rights to the three largest rivers of the basin, amounting to 80 percent of flows, says Kugelman. “The broader reality is that there has actually been a fair level of cooperation between these two enemies in managing transboundary water resources in the Indus Basin.” Climate change and rapid population growth are changing conditions significantly and there have been calls on both sides for the treaty to be renegotiated, but Kugelman believes there is not enough trust between the two for a renegotiation to be productive at the moment. “It is 100 percent wrong to claim that water is a soft issue, that the two sides can use water as a confidence building measure,” he asserts. Resolu(continued)

The Sahel region of Africa is a wide band that marks the transition from the Sahara Desert in the north to the wetter, sub-tropical regions in the south. The Sahelian countries have some of the most rapidly growing populations in the world and have faced significant environmental change over the past century. In recent years, insurgencies have surged in several countries, new terrorist groups have become active, there have been several droughts, and migration has increased. “We firmly believe that without development, the security situation in the Sahel will worsen, generating enormous human and financial costs for countries in and around the region as well as in Europe,” says Christophe Angely of the France-based Foundation for International Development Study and Research (FERDI) in this week’s podcast. FERDI recently completed a two-year transdisciplinary research project of the region, pulling information from researchers on the ground and from France’s military intervention in Mali. “We got a very alarming message about what was happening,” Angely says – and about people’s outlook. There are major demographic, economic, social, environmental, and institutional challenges, but they are not insurmountable, he says. “Our plea seeks to overcome the prevailing pessimism about the Sahel’s economic potential, which leads some to believe…that the only solution for people is to migrate outside the Sahel zone.” Angely’s first proposal? Reinvest in education. The international community has dramatically reduced aid for education in the Sahel since 2009, says Angely. In 2014, France allocated just 13 percent of its programmable aid to the education sector, and the United States and other multilateral donors allocated only 2 percent. Combined with rapid growth in school enrollment, thanks to youthful and growing populations, this has left Sahelian states unable to fund education alone. Sustainable Development Goal 4, to ensure inclusive, equitable, and quality education for all, “demands…a rethink of the funding strategies of education, given that national government, private funders, and international donors are increasingly difficult to coordinate,” Angely explains. He calls for not only more schools, but better training for teachers and supervision that can protect girls from the kind of violence that has played out in northern Nigeria and discourages many from attending. FERDI also recommends a new approach to agriculture. Instead of sticking with historic patterns of expanding surface area to increase production, Angely argues that policymakers should encourage farmers to improve yields on existing plots. He also calls for selecting more diverse crops, encouraging young people to get involved in the industry, smoothing price variability for exporters, and promoting better coordination in the sector generally. These solutions not only promote food security, they provide benefits to local economies. “Small-scale processing food or agriculture is probably where you get the most reserve of jobs,” Angely says. Angely’s final recommendation is to strengthen national administration capacities. The Sahel countries need better democratic models, he says; in many, democracies are “more formal than real.” Elected officials tend to focus on reelection and capitalizing on differences between groups instead of responding to the needs of all citizens. Donors should work to create long-term programs that not only support key ministries such as education, but are also able to manage pressures such as food insecurity without creating conflict or triggering violence, he says. “People need to rediscover their face in progress and feel more confident about the rule of their states. This is why it must be the objectives of all actions in the region to favor a balance between quick impact activities and actions that are effective over the long term.” Christophe Angely spoke at the Wilson Center on April 25. Do(continued)

The Sahel region of Africa is a wide band that marks the transition from the Sahara Desert in the north to the wetter, sub-tropical regions in the south. The Sahelian countries have some of the most rapidly growing populations in the world and have faced significant environmental change over the past century. In recent years, insurgencies have surged in several countries, new terrorist groups have become active, there have been several droughts, and migration has increased. “We firmly believe that without development, the security situation in the Sahel will worsen, generating enormous human and financial costs for countries in and around the region as well as in Europe,” says Christophe Angely of the France-based Foundation for International Development Study and Research (FERDI) in this week’s podcast. FERDI recently completed a two-year transdisciplinary research project of the region, pulling information from researchers on the ground and from France’s military intervention in Mali. “We got a very alarming message about what was happening,” Angely says – and about people’s outlook. There are major demographic, economic, social, environmental, and institutional challenges, but they are not insurmountable, he says. “Our plea seeks to overcome the prevailing pessimism about the Sahel’s economic potential, which leads some to believe…that the only solution for people is to migrate outside the Sahel zone.” Angely’s first proposal? Reinvest in education. The international community has dramatically reduced aid for education in the Sahel since 2009, says Angely. In 2014, France allocated just 13 percent of its programmable aid to the education sector, and the United States and other multilateral donors allocated only 2 percent. Combined with rapid growth in school enrollment, thanks to youthful and growing populations, this has left Sahelian states unable to fund education alone. Sustainable Development Goal 4, to ensure inclusive, equitable, and quality education for all, “demands…a rethink of the funding strategies of education, given that national government, private funders, and international donors are increasingly difficult to coordinate,” Angely explains. He calls for not only more schools, but better training for teachers and supervision that can protect girls from the kind of violence that has played out in northern Nigeria and discourages many from attending. FERDI also recommends a new approach to agriculture. Instead of sticking with historic patterns of expanding surface area to increase production, Angely argues that policymakers should encourage farmers to improve yields on existing plots. He also calls for selecting more diverse crops, encouraging young people to get involved in the industry, smoothing price variability for exporters, and promoting better coordination in the sector generally. These solutions not only promote food security, they provide benefits to local economies. “Small-scale processing food or agriculture is probably where you get the most reserve of jobs,” Angely says. Angely’s final recommendation is to strengthen national administration capacities. The Sahel countries need better democratic models, he says; in many, democracies are “more formal than real.” Elected officials tend to focus on reelection and capitalizing on differences between groups instead of responding to the needs of all citizens. Donors should work to create long-term programs that not only support key ministries such as education, but are also able to manage pressures such as food insecurity without creating conflict or triggering violence, he says. “People need to rediscover their face in progress and feel more confident about the rule of their states. This is why it must be the objectives of all actions in the region to favor a balance between quick impact activities and actions that are effective over the long term.” Christophe Angely spoke at the Wilson Center on April 25. Do(continued)

Governments and health organizations have made remarkable gains in reducing maternal mortality and morbidity rates around the world. Much of those gains have been driven by increasing capacity, directing more women to hospitals and clinics to ensure they get modern medical care. Increasingly, however, experts are realizing that this push has brought challenges of its own. “We have these huge numbers of women going into hospitals with three to a bed and overcrowded hospitals and terrible conditions, and we have not improved the outcomes,” says Saraswathi Vedam, an associate professor and lead investigator at the University of British Columbia’s Birth Place Lab, in this week’s podcast. “Institutional birth has not been shown to be the answer,” she says. Instead, “it’s about skilled attendants and respectful care.” Under crowded and hectic conditions, many women feel pressure to undergo unnecessary obstetric interventions that are both expensive and dangerous, including Caesarean sections (C-sections) and episiotomies, a phenomenon The Lancet refers to as “too much, too soon.” “When we talk about interventions and too much too soon,” Vedam says, “we need to understand who’s making the decisions, what’s driving the decisions.” The Birth Place Lab created the Mother’s Autonomy in Decision Making (MADM) scale and the Mothers on Respect (MOR) index to help quantify the experiences of expecting women and families and record their perceptions of respect and agency throughout the process. Among the nearly 3,400 women from various backgrounds who took part in the Changing Childbirth in British Columbia study, for example, 95 percent said it was “very important” or “important” that they lead the decisions about their own pregnancy, birth, and baby care. Yet, the bulk of the decisions are being driven by providers. Among respondents in three recent maternal care studies, “two in five women felt pressured to have a C-section,” Vedam says. “It wasn’t whether they had the intervention [that affected their perception of care], it was whether or not they felt involved in decision-making.” Women consistently responded to more personalized and higher quality care. Midwifery clients reported more respectful treatment wherever they delivered, Vedam says, as well as higher autonomy scores. “We think that it has something to do with time,” she says. When women have enough time to consider their options and make more informed choices, maternal care is more collaborative, and costly and risky over-interventions are avoided. Saraswathi Vedam spoke at the Wilson Center on April 24, 2017. Friday Podcasts are also available for download on iTunes and Google Play.

Governments and health organizations have made remarkable gains in reducing maternal mortality and morbidity rates around the world. Much of those gains have been driven by increasing capacity, directing more women to hospitals and clinics to ensure they get modern medical care. Increasingly, however, experts are realizing that this push has brought challenges of its own. “We have these huge numbers of women going into hospitals with three to a bed and overcrowded hospitals and terrible conditions, and we have not improved the outcomes,” says Saraswathi Vedam, an associate professor and lead investigator at the University of British Columbia’s Birth Place Lab, in this week’s podcast. “Institutional birth has not been shown to be the answer,” she says. Instead, “it’s about skilled attendants and respectful care.” Under crowded and hectic conditions, many women feel pressure to undergo unnecessary obstetric interventions that are both expensive and dangerous, including Caesarean sections (C-sections) and episiotomies, a phenomenon The Lancet refers to as “too much, too soon.” “When we talk about interventions and too much too soon,” Vedam says, “we need to understand who’s making the decisions, what’s driving the decisions.” The Birth Place Lab created the Mother’s Autonomy in Decision Making (MADM) scale and the Mothers on Respect (MOR) index to help quantify the experiences of expecting women and families and record their perceptions of respect and agency throughout the process. Among the nearly 3,400 women from various backgrounds who took part in the Changing Childbirth in British Columbia study, for example, 95 percent said it was “very important” or “important” that they lead the decisions about their own pregnancy, birth, and baby care. Yet, the bulk of the decisions are being driven by providers. Among respondents in three recent maternal care studies, “two in five women felt pressured to have a C-section,” Vedam says. “It wasn’t whether they had the intervention [that affected their perception of care], it was whether or not they felt involved in decision-making.” Women consistently responded to more personalized and higher quality care. Midwifery clients reported more respectful treatment wherever they delivered, Vedam says, as well as higher autonomy scores. “We think that it has something to do with time,” she says. When women have enough time to consider their options and make more informed choices, maternal care is more collaborative, and costly and risky over-interventions are avoided. Saraswathi Vedam spoke at the Wilson Center on April 24, 2017. Friday Podcasts are also available for download on iTunes and Google Play.

As more and more development and humanitarian programs contend with climate-related problems, there are important lessons learned from past experience that should not be forgotten, says Janani Vivekananda, formerly of International Alert and now with adelphi, in this week’s episode of “Backdraft.” In her work with International Alert, Vivekananda found there was often a misconception that all renewable energy projects are an “unalloyed good.” But renewable energy efforts still require access to resources, like land and water, which can be highly contested (listen to Stacy VanDeveer in Backdraft #2 for more on this). Traditional extractive industries like oil and gas have grappled with conflict risks in the communities they work for decades, to greater and lesser degrees of success, but little of that experience has transferred over to the renewable sector, she says. Vivekananda says that development actors looking to encourage renewable energy projects should strive to understand local power dynamics as much as possible – who controls assets, and is it through formal or informal agreements, treaties, etc. “Then understand how your intervention is going to affect and change this and who the winners and losers are going to be.” There can be significant financial and social costs when conflict-sensitivity is not built into program design. Vivekananda gives the example of a wind farm in northwest Kenya proposed by a large international bank. The consultation process focused on elites at the district level, but did not include local non-elites who would be directly affected by the project. Consequently, the project broke down as the project organizers realized too late that the land required was already highly contested. “These local contextual conflict dynamics were not fed into program design,” says Vivekananda, “and it was a very expensive way to learn about the need to ensure that an intervention was conflict-sensitive.” Humanitarian interventions are another response that by their very nature – immediate, short-term, and urgent – often do not plan for longer-term impacts. As groups rush to fill the burgeoning global need, “we’re seeing then that humanitarian interventions are climate blind and conflict blind,” says Vivekananda. Refugee camps, like Zaatari in Jordan which houses nearly 80,000 refugees, are often built without sustainable water or energy use plans. Groundwater extraction in Zaatari has inflated the local water market making it difficult for surrounding communities to afford water, thereby increasing tensions, says Vivekananda. To address gaps in planning, Vivekananda says a shift in mindset is needed not only at the practitioner level, but at the political level. By incorporating a sustainable development and conflict-sensitive lens at the outset, interventions can not only help avoid conflict but actively increase cohesion and trust. In Kibera, a large informal settlement in Nairobi, Vivekananda and her colleagues saw firsthand the peace dividends that can come from a forward-looking, participatory planning approach. They found that the projects most likely to increase community resilience – to both conflict and climate risks like flooding – were the ones that “through their process involve people in decisions and planning and are participatory by nature and therefore build trust between the communities affected and the government.” Interventions with a single sector approach – e.g., moving people from informal shacks to more sturdy structures – sometimes inadvertently undermined social networks and ultimately had a negative impact on community resilience. “That social cohesion is critical and if you’re intervening in a way that dislocates that, undermines that, it’s unlikely to take hold,” says Vivekananda. The “Backdraft” podcast series is hosted and co-produced by Lauren Herzer Risi and Sean Peoples, a freelance multimedia producer based in Washington, DC. Frida(continued)

As more and more development and humanitarian programs contend with climate-related problems, there are important lessons learned from past experience that should not be forgotten, says Janani Vivekananda, formerly of International Alert and now with adelphi, in this week’s episode of “Backdraft.” In her work with International Alert, Vivekananda found there was often a misconception that all renewable energy projects are an “unalloyed good.” But renewable energy efforts still require access to resources, like land and water, which can be highly contested (listen to Stacy VanDeveer in Backdraft #2 for more on this). Traditional extractive industries like oil and gas have grappled with conflict risks in the communities they work for decades, to greater and lesser degrees of success, but little of that experience has transferred over to the renewable sector, she says. Vivekananda says that development actors looking to encourage renewable energy projects should strive to understand local power dynamics as much as possible – who controls assets, and is it through formal or informal agreements, treaties, etc. “Then understand how your intervention is going to affect and change this and who the winners and losers are going to be.” There can be significant financial and social costs when conflict-sensitivity is not built into program design. Vivekananda gives the example of a wind farm in northwest Kenya proposed by a large international bank. The consultation process focused on elites at the district level, but did not include local non-elites who would be directly affected by the project. Consequently, the project broke down as the project organizers realized too late that the land required was already highly contested. “These local contextual conflict dynamics were not fed into program design,” says Vivekananda, “and it was a very expensive way to learn about the need to ensure that an intervention was conflict-sensitive.” Humanitarian interventions are another response that by their very nature – immediate, short-term, and urgent – often do not plan for longer-term impacts. As groups rush to fill the burgeoning global need, “we’re seeing then that humanitarian interventions are climate blind and conflict blind,” says Vivekananda. Refugee camps, like Zaatari in Jordan which houses nearly 80,000 refugees, are often built without sustainable water or energy use plans. Groundwater extraction in Zaatari has inflated the local water market making it difficult for surrounding communities to afford water, thereby increasing tensions, says Vivekananda. To address gaps in planning, Vivekananda says a shift in mindset is needed not only at the practitioner level, but at the political level. By incorporating a sustainable development and conflict-sensitive lens at the outset, interventions can not only help avoid conflict but actively increase cohesion and trust. In Kibera, a large informal settlement in Nairobi, Vivekananda and her colleagues saw firsthand the peace dividends that can come from a forward-looking, participatory planning approach. They found that the projects most likely to increase community resilience – to both conflict and climate risks like flooding – were the ones that “through their process involve people in decisions and planning and are participatory by nature and therefore build trust between the communities affected and the government.” Interventions with a single sector approach – e.g., moving people from informal shacks to more sturdy structures – sometimes inadvertently undermined social networks and ultimately had a negative impact on community resilience. “That social cohesion is critical and if you’re intervening in a way that dislocates that, undermines that, it’s unlikely to take hold,” says Vivekananda. The “Backdraft” podcast series is hosted and co-produced by Lauren Herzer Risi and Sean Peoples, a freelance multimedia producer based in Washington, DC. Frida(continued)