appeal no: 05/96 : INTEGRATED 15 March 1996 HEALTH & BRANCH DEVELOPMENT PROGRAMME THIS APPEAL SEEKS CHF 7,807,000 IN CASH, KIND AND SERVICES TO ASSIST 600,000 BENEFICIARIES FOR 9 MONTHS

Summary 's longest civil war in modern times finally appeared to end on 20 November 1994 with the signing of a peace agreement in Lusaka, Zambia, by the Angolan government and the UNITA rebel group. The agreement came only two years after a return to fighting following UNITA’s refusal to accept the results of an election which swept the MPLA government back into power, but 21 years after the war began in the scramble to replace the Portuguese colonial regime. Fifteen months after the signing of the peace accord, the legacy of the war remains largely intact. Angola's economy and infrastructure is shattered, its mineral wealth stripped (though large natural resources remain) and its politics polarised into mutual distrust and suspicion backed by huge quantities of arms. Only 500 soldiers had been completely de-mobilised by the UN peacekeeping force at the end of 1995, leaving tens of thousands of soldiers still to be re-integrated into civilian life. Negotiations between the two parties are moving forward cautiously, but with the passing of time peace is taking a firmer grip on Angola, making a return to hostilities increasingly unlikely, though not impossible. Given this gloomy scenario, the importance of a rapid and successful beginning to the long process of rehabilitation and reconstruction becomes even greater. The Intended Operation After many years of experience in emergency relief, the time is ripe for the Angolan Red Cross Society (ARCS) to undertake an expansion of its present rehabilitation and development activities in six to cover the most populated 12 provinces of Angola within the next two years, and all 18 provinces by 1999. The proposed Integrated Branch and Community Health Development Programme will emphasise traditional activities of the Red Cross — including the running of health posts and community-based first aid — but will also cover services like maternal health centres, targeted relief and social welfare assistance, mine awareness, and Red Cross branch rehabilitation, with a general focus on institutional and resource development. This appeal, for CHF 7,807,000, is for operations in 1996 only. However, the Federation's two-phase plan of action extends for much longer. The first phase runs from 1996 to 1998 and the appeal no. 05/95 second from 1999 to 2003. Details on later phases of the operation will be finalised as progress in the peace process and the capacity of the National Society become clearer. The Disaster

Virtually the entire population of Angola was affected either directly or indirectly by the resumption of the civil war in October 1992. The renewed fighting resulted in further loss of life, massive population displacement and the continuing diversion of labour away from production to fighting. Meanwhile, the government’s provision of essential services such as health, water, sanitation and education was severely curtailed due to insecurity and a collapse in economic resources. This decline in health provision was reflected in rocketing rates of infant mortality (200 per 1,000 live births) and maternal mortality (more that 1,000 per 100,000 births).

Although political progress between the government and the UNITA rebels is stuttering and extremely slow — the present peace in Angola offers the best opportunity for over 21 years to begin major reconstruction and development work. For this reason, the Federation intends to increase substantially its support to the Angolan Red Cross to ensure the National Society makes a meaningful contribution towards the country’s recovery and future development. The Response so far

Government Action The government of Angola is presently allocating 40% of its budget to the Ministry of Defence, while the Ministry of Health receives 5%, Education 6%, Social Assistance 5% and Housing 2%. The strongest government involvement in humanitarian issues is taking place through the Ministry of Social Affairs and Reintegration (MINARS). Although the primary role of MINARS is to facilitate the demobilisation process of soldiers, it is also participating in the activities of the Humanitarian Co-ordination Group (HCG).

Red Cross/Red Crescent Action The ARCS occupies a unique position in Angola as the only national humanitarian organisation present in all provinces which has a permanent commitment to assist the most vulnerable groups. The ARCS is currently providing basic health services in collaboration with the Ministry of Health in 14 health posts and food and non-food commodities to displaced and other vulnerable people in six provinces. Unfortunately, the National Society is not able to do more because of the severe effects of the war. The ARCS lost staff and volunteers in the conflict, and struggles at the moment due to a lack of professional skills and poor internal funding. Training activities (courses and on-the-job training) have therefore been initiated by the Federation to strengthen gradually the National Society’s structure and operational capacity. Participating National Societies (PNS), through the Federation, are providing technical and financial support to all these activities.

Other Agencies’ Action More than 114 national and international non-governmental and other humanitarian organisations are currently operating in Angola (a number which does not include UN agencies). These organisations are present in all 18 of Angola’s provinces, carrying out health and nutrition, food and non-food, education, water and sanitation, and mine action programmes.

Co-ordination The UN’s Department of Humanitarian Affairs (DHA) is present in Angola under the UCAH acronym (Humanitarian Assistance Co-ordination Unit). UCAH is co-ordinating

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the activities of UN agencies and other organisations working on emergency relief, the demobilisation and integration of ex-soldiers, as well on mine-related activities. Those organisations working with food assistance are co-ordinated by WFP. Until now, UNICEF has co-ordinated all health activities but this role will probably be taken over by WHO soon. The Humanitarian Co-ordination Group is the forum in which relief activities and policies in Angola are discussed. Members of the HCG include UCAH (representing UN agencies), the Angolan government (mainly MINARS), UNITA and the group of observer countries (Portugal, Russia and USA). ICRC, the Federation and a few other entities have observer status at the HCG. The Needs to be met

Assessment of Needs A Federation team visited Angola in January to review and plan a Post-War Angola Red Cross Health and Branch Rehabilitation and Development Programme. The mission team facilitated a three-day joint planning workshop for the ARCS staff and Federation delegation. The material was used to design a draft programme strategy, specific objectives and an accompanying budget. The strategy document has been endorsed by the National Society.

Immediate Needs In order to guarantee effective support to the proposed programme, the ARCS needs to hold its General Assembly within the next months. This will provide the necessary legal instrument to re-establish the governance and administrative structures of the National Societies.

Anticipated Later Needs The detailed identification of later needs depends on the evaluation outcome of the first programme phase. Red Cross Objectives

To provide food and non-food relief to 150,000 people (double the 1995 level) directly affected by the war in 12 provinces (, Kwanza Norte/Sul, , Huila, Namibe, Bengo, Uige, Malange, Bie, Cunene, Cuando-Cubango). To rehabilitate and open eight new health posts and two Mother/Child health care centres (MCH), and thus provide all the elements of essential care to an estimated population of 600,000 people in accordance with national health plans and policies. To drill ten water points and construct 20 latrines to serve ten health posts and local communities receiving assistance through these health posts. To provide mine awareness and education training to an estimated population of 200,000 in three provinces (Zaire, Lunda Norte, Lunda Sul) through 90 trained ARC volunteers. These volunteers will be equipped with graphic and promotional material, training curricula and bicycles for outreach to neighbouring districts. The programme will also be carried out in collaboration with Norwegian People’s Aid, who will train and equip the ARCS volunteers while the Federation/ARCS co-ordinates and monitors their activities. To provide social welfare assistance in six provinces to 200 physically-disabled persons (mainly amputees) through the identification of those in need of artificial limbs, the provision of transport and post-treatment follow-up in the form of vocational training to meet basic needs. Assessments will be conducted in each target community.

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To provide psycho-social support for an estimated 600 persons in six provinces through preventive and therapeutic counselling and occupational and educational activities. This support will be organised around selected health facilities through specifically developed programmes and will utilise trained Red Cross youth and volunteers as essential care givers. Assessments will be conducted in each target community. To facilitate the process leading the ARCS towards the status of a well-functioning National Society in terms of governance, management, branch structures and programme activities. To train four managers at national headquarters and in each of the selected 12 provinces in leadership, management, institutional, resource and programme development. To train 480 Red Cross youth and volunteers in basic health education and first aid. To initiate planning for viable and sustainable revenue generation and fund-raising activities through training, follow-up and selective financial support in order to gradually reduce the National Society’s dependency on external financing for its core activities. To establish operational guidelines to ensure the high quality and consistency of ARCS/Federation co-ordinated programmes and thus develop a framework for effective communication and accountability.

National Society/Federation Plan of Action

The Federation and PNS will coordinate to provide strong managerial, technical and material support to the ARCS as the front-line agency in the implementation of the proposed Post-War Integrated Health and Branch Development Programme. It is therefore important, given the prevailing political and economic context, that the scale, scope and rate of development and expansion of the Red Cross programme be continually determined by the capacity and readiness of ARCS and its branches.

Implementation of the proposed programme is planned to take place in two phases. The first phase — between 1996-1998 — emphasises the consolidation of existing and the expansion of new health, relief and social welfare activities, institutional development and the establishment of a base for resource development. This phase would be carefully evaluated during the third year to assess the efficiency (process) and effectiveness (outcome) of the programme. In order to provide more support to ARCS operations, three sub-offices will be established in Huíla, Benguela and Uige in addition to the Luanda delegation.

The results of this evaluation will enable the Federation to develop a detailed three- to five-year (second phase) plan to cover at least six more provinces (Bengo, Uige, Malange, Bie, Cunene and Cuando-Cubango), while reducing expatriate delegates’ involvement in the initial six provinces (Luanda, Kwanza Norte, Kwanza Sul, Benguela, Huila and Namibe). While the Federation’s plan of action is divided into two phases: 1996-1998 and 1999-2003, this appeal covers a one year period only. Flexibility is essential, especially during the first phase as much depends on the progress of the peace process, the ARCS General Assembly and the developing capacity of the National Society

Phase One / Year One — March 1996 - December 1996 Health.

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Priority will be given to the rehabilitation and strengthening of traditional Red Cross health activities, in particular, the mobilisation and management of community-based first aid with the participation of Red Cross volunteers. As Angola’s health system has virtually collapsed, the ARC/Federation essential health care programme must be expanded both in terms of geographical coverage and Primary Health Care (PHC) interventions. Eight health posts and two Mother and Child care centres will be rehabilitated in six new provinces, while work in the existing 14 health posts (in six other provinces) will continue.

The existing and new facilities will hold more than 600,000 patient consultations in the first year. The health posts and centres will provide MCH services, immunisation, nutritional, curative and preventive services, including the supply of essential drugs and control and management of common diseases. HlV/AIDS, maternal health/family planning and water/sanitation projects will also be strengthened or expanded.

The ARCS/Federation will promote, in collaboration with the health authorities and UNICEF, a process leading to the development of national guidelines for the implementation of PHC within the context of the district health system.

The terms and conditions for the involvement of the ARCS/Federation will be detailed in an agreement drawn up with the national health authorities. Once the posts can be run on a cost-recovery basis, the facilities will be handed over either to the Ministry of Health or the ARCS. The MCH centres will remain under government administration but with agreed support and oversight.

Relief and Social Action The ARCS/Federation will continue providing food and non-food relief and social welfare assistance to 150,000 people directly affected by the war (internally displaced, those with disabilities, children in specially difficult circumstances). On-the-job training of staff and volunteers in various aspects of relief operations will increase the disaster preparedness and response capacity of the ARCS. Distributions of seeds, agricultural tools and related supplies will also help the psycho-social and economic rehabilitation of these and other vulnerable groups.

Human Resource Development/Training Training covering management, leadership, institutional, resource and programme development; health; logistics and mine awareness will be given to ARCS staff at the ARCS Viana Training Centre in Luanda. During this first phase of the programme the aim will be to train 480 staff and volunteers from the national headquarters and each of the six — then 12 — selected provinces. Eighty people will be trained in development-related disciplines, 210 in health (including youth volunteers and trainers), 100 in logistics and 90 in mine awareness.

Institutional Development It is vital to establish written contractual agreements between the ARCS and key partners, such as a Memorandum of Understanding between the National Society, the Federation and collaborating PNS. A similar process must be undertaken with the Ministry of Health before the end of the period.

Standardised operational guidelines for ARCS/Federation work will be drawn up to streamline managerial operations and branch structures. Participatory planning, budgeting and review processes will be initiated at all levels which, in combination with effective communication mechanisms, will strengthen the ARCS’s structure by introducing an appropriate delegation of responsibility and authority.

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The Federation will assist the National Society in its planning and holding of a General Assembly, scheduled for June 1996.

Financial Resource Development The ARCS/Federation are attempting to take a bold step away from emergency relief towards long-term development, implying a commitment to enable the National Society to move towards financial independence. The process will begin of elaborating revenue generating policies, guidelines and a plan to reduce ARCS dependence on external funding.

Phase One / Years Two & Three — January 1997 - December 1998 An updated plan of action will be produced as 1997 draws nearer. In the meantime, it is envisaged that activities will proceed as follows: Rehabilitation and construction of 12 new health posts and four maternal health centres in 1997, plus a further 15 posts and five maternal health centres in 1998; Relief and social welfare needs will depend upon the health and nutritional status of target populations, the developing agricultural productivity and food security in Angola and the results of a 1996 needs assessment among war-affected children, disabled people, and other vulnerable groups; Institutional and resource development activities will continue based on the progress made in 1996.

Phase Two — 1999-2003 The second phase of the programme will be drafted in detail only after an extensive evaluation of the first phase and an analysis of the prevailing conditions in Angola. Adjustments of schedules and programmes will certainly have to be made to respond to changing needs and priorities, but it is hoped that the most successful elements of the Red Cross’ phase one activities will be implemented in six more provinces. During this second phase, the ARCS will focus more on long-term activities which are auxiliary to rather than a replacement of government-run services. Such long-term activities would also be based on the ability of the National Society to sustain them with locally-available resources.

Capacity of the National Society The ARCS is the only national non-governmental organisation present in all provinces of the country. This position places a great responsibility on the National Society to fulfil its mission as an auxiliary to the government through its staff and volunteers. To do this effectively, written agreements with the government providing a framework for partnership and joint action will be developed during the first phase of the proposed programme.

The ARCS has not been able to carry out statutory meetings for a prolonged period, partially because of the internal conflict. As a result, adequate governance and administrative structures are not in place. The current statutes also need to be reviewed. The process is under way to convene a General Assembly later this year. Currently the National Society is heavily dependent on external financial support, but potential exists for revenue generation which must be exploited to achieve increased financial independence in future. Institutional and resource development activities will therefore be emphasised in the programme.

Present Capacity of the Federation in Angola

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The Federation delegation in Angola is currently composed of eight delegates covering the areas of logistics, health, institutional development, training and administration. Two of the delegates, based in Benguela, are responsible for the programmes in three central-southern provinces while the office in Luanda provides assistance for activities in the remaining provinces — all with corresponding support by locally-employed persons. Part of the delegation in Luanda has recently moved to ARCS premises to achieve closer and more efficient programme coordination with National Society counterparts.

Implementation of the proposed programme will require up to 20 highly qualified and experienced expatriates in relevant technical and managerial disciplines. Depending on the outcome of the peace process and the readiness of the health authorities and the ARCS to take over and maintain the programme, the number of delegates would decrease from the third year. The strategy will be to enable ARCS staff and volunteers at all levels to take up responsibilities for programme implementation as soon as possible.

Evaluation During the third year, an external evaluation of the efficiency and effectiveness of the programme will be carried out in order to develop a detailed three- to five-year second phase, with the aim of covering six more provinces (and therefore the entire country) while reducing, gradually, expatriate delegate involvement in the provinces presently being covered. However, the slow implementation of Angola’s peace process as well as the unpredictable political and economic conditions will require close monitoring of the programme’s implementation and results to enable the ARCS and the Federation to adapt quickly to new situations and challenges. Immediate action

The ARCS must be strongly supported to carry out its statutory obligations without delay. This will pave the way for the establishment of solid structures and clear institutional policy and operational guidelines, which will enable the National Society to regain the confidence of its key partners. An increase in Federation support for multiple training activities and an emphasis on branch development combined with rehabilitation of the National Society’s structures are essential. Meanwhile, the ARCS/Federation relief and health services to the most vulnerable will continue, gradually expanding guided by needs and the real capacities of local and national Red Cross structures. Budget summary

See Annex 1 for details.

As discussed in the donor's consultation meeting in November 1995, the Secretariat is amenable to project delegation forms of collaboration with interested national societies. Detailed budget figures by will be available shortly for those societies interested in assuming responsibility, under the overall coordination and guidance of the Federation , for particular projects or sectors within this appeal. Donors should contact the Programme Officer for Southern Africa to discuss details. Conclusion

The level and effectiveness of the participation of the Angolan Red Cross in the ongoing post-war recuperation and rehabilitation activities will largely determine its future role in Angolan society. The Federation believes it is vital that it regains its role as the leading national humanitarian organisation, working as an auxiliary to the authorities. To achieve 7 appeal no. 05/95

this will be a major challenge both for the National Society and the international donor community. It is a challenge we urge the Federation’s donors to take up.

Margareta Wahlström George Weber Under-Secretary General, Secretary General Disaster Response Operations Coordination

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