United States Agency for International Development Bureau for Humanitarian Assistance Office of Food for Peace Final Performance Report Awardee Name and Host Country CitiHope International Host/Implementation Country Dominican Republic Award Number 72DFFP19FA00003 Project Name USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación Activity Start Date 9/30/2019 Activity End Date 2/28/2021 Submission Date 3/30/2021 Awardee HQ Contact Name Paul Moore II Awardee HQ Contact Address PO Box 626, Margaretville, NY 12455 Awardee HQ Contact Telephone Number 845-586-6202 Awardee HQ Contact Email Address [email protected] Host Country Office Contact Name Tim Tuccelli Host Country Office Contact Telephone 809-729-9099 Number Host Country Office Contact Email [email protected] Address LIST OF ACRONYMS ADS Automated Directives System AER Annual Estimate of Requirements AIDS acquired immune deficiency syndrome AOR agreement officer’s representative (formerly agreement officer’s technical representative or cognizant technical officer) ARR annual results report ARR PRT Annual Results Report Partner Reporting Tool ART Anti-retroviral therapy BEHT Bill Emerson Humanitarian Trust BHA Bureau for Humanitarian Assistance CHI CitiHope International CHI-DR CitiHope-Dominican Republic DEC Development Experience Clearinghouse DIP detailed implementation plan DQA data quality assessment FFP Office of Food for Peace FFP/M/R Office of Food for Peace/Mission and/or Regional Office, as appropriate FFP/W Office of Food for Peace/Washington FFPIB Food for Peace Information Bulletin FY fiscal year (October 1st - September 30th) HIV human immunodeficiency virus IDP internally displaced person IFRP International Food Relief Partnership IPTT indicator performance tracking table LOA life of award LOP life of program NGO Non-governmental organization OVC Orphans and Vulnerable Children PPE personal protective equipment PREP pipeline and resource estimate proposal SAPQ standardized annual performance questionnaire USAID United States Agency for International Development 1 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación 1. Report Narrative A. Activity Interventions and Results Award Summary: Objectives and Beneficiaries The objective of this food aid program is to provide critically needed nutritional support in the form of Breedlove Harvest Lentil Pro® food supplement to community health programs, hospitals and care centers serving vulnerable populations at risk of malnutrition, including orphans and vulnerable children (OVCs), pregnant women and lactating mothers (PWLM), people living with HIV and AIDS (PLWHA), hospital patients, and elderly in the Dominican Republic (DR). These beneficiaries were selected because they are the most vulnerable children and adults in the region with very limited access to sufficient food or nutritional supplementation. The recipient institutions are maternal and children’s health care centers, community health care programs, general nutrition programs, orphanages, HIV treatment programs, schools, geriatric care programs, special needs centers, medical operatives and a nutritional aid program for undernourished patients preparing for humanitarian surgical operatives in the Dominican Republic. CitiHope International-Dominican Republic (CHI-DR) works directly with beneficiary institutions across the island and initially targeted 24,408 OVCs, PWLM, PLWHA, hospital patients, and the elderly in this program, delivering 150.08 metric tons (MT) of Harvest Lentil Pro®. Several factors affected our original distribution plan. The COVID-19 pandemic has created an extreme food shortage in the Dominican Republic due to loss of income from the shutdown and to the ongoing effects of the 2019 blight and drought in agricultural areas. As educational and daycare centers were closed our distribution plan adjusted to provide increased support to family nutrition programs. Prior to the pandemic, CHI-DR had planned to distribute a portion of the Harvest Lentil Pro® to school feeding programs which prepared meals on site for students. When these school feeding programs closed and schools shifted to providing food distribution to students’ entire families, CHI-DR shifted to providing Harvest Lentil Pro® to these family distributions, resulting in significantly more beneficiaries than originally planned. The ration size per beneficiary was adjusted based on updated needs assessment and consultation with participating institutions, allowing for entire families to be reached. In addition, the Dominican Ministry of Health and military, which led the Dominican Republic’s network of COVID-19 first responders, requested that CHI-DR add COVID-19 patients to the 2 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación food distribution. Military hospitals were set up in March for isolation and COVID-19 patient care. The military medical directors requested assistance from CHI-DR for COVID-19 related personal protective equipment (PPE), medicines, and nutrition. CHI-DR, through its Sanar una Nación (Heal A Nation) alliance with leading Dominican corporations which provide financial and in-kind support, provided PPE, medicines and the USAID Breedlove Harvest Lentil Pro® for hospitals, isolation centers and to families in home isolation. Over 500 COVID-19 patients and families in isolation received Harvest Lentil Pro®, which was also provided to medical professionals serving in hospitals and traveling around the island tracking the pandemic. In total, 63,115 persons, including children, families, PWLM, OVCs, PLWHA, elderly persons, COVID-19 patients, and their families, have been reached with nutritional assistance through this program. This IFRP program assisted the local medical infrastructure in caring for vulnerable patients through the following objectives: 1.) Provide nutritional support for populations at risk of chronic malnutrition so that they may reach their potential in physical and behavioral development. 2.) Provide urgent nutrition for COVID-19 patients and their families, during isolation treatment and recovery. In addition, provide nutritional support to the many thousands that were affected by the COVID-19 shutdown and quarantine. 3.) For those patients with HIV/AIDS, provide the additional nutritional support necessary to complement antiretroviral therapy (ART). Patients with HIV/AIDS need to consume 10 to 20 percent more calories than those who are HIV negative. 4.) Provide safe, non-contaminated nutritional supplementation in areas where environmental hazards can traditionally cause parasite/bacterial contamination. 5.) Provide nutrition training to community leaders, health care providers, and caregivers to encourage behavior changes in targeted at-risk populations. 6.) Improve quality, efficiency, and safety of institutional food service capabilities by providing supplemental nutrition to add to complementary foods. 7.) Provide greater food security for an institutionalized segment of the population of the DR. Distribution CHI worked with Breedlove staff to secure a freight-forwarder to manage the international shipping of the commodity from the U.S.A. to CHI-DR warehousing facilities in San Isidro, Santo Domingo Este via Rio Haina port. CHI-DR, which currently clears several shipping containers of humanitarian aid per month in collaboration with Grupo Rica customs services, facilitated the clearing process of the commodities through Dominican Customs. CHI-DR then coordinated directly with recipient institutions to transport the commodity and safely store it 3 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación in existing pre-approved storage facilities for further distribution to urban and rural areas, drawing upon its extensive experience in such large-scale distributions in Dominican Republic based on its ongoing medical and nutritional humanitarian program, Sanar Una Nación. The 8 40-foot containers of Harvest Lentil Pro® were shipped to the Dominican Republic in two installments. The first four containers shipped from Breedlove Foods on February 4, 2020 and arrived in the Dominican Republic in early March. The final four containers shipped from Breedlove Foods on March 6, 2020 and arrived in the Dominican Republic in early April. As the COVID-19 pandemic began to spread through communities in late March, CHI-DR reevaluated needs with government authorities, such as the Ministry of Health and the military, and the corporate leadership of our Sanar una Nación alliance. Upon careful evaluation with our beneficiary organizations, distribution was reestablished focusing on the COVID-19 response and keeping sight on our established nutrition programs with our trusted network of institutions. CHI-DR staff and distribution partners were trained and observed protocols to prevent the spread of COVID-19 during the distribution of the food commodity. COVID-19 protocols included mask wearing, physical distancing, and handwashing/hand sanitizing. Where prudent, face shields and overalls were provided for staff and partners during distribution activities. Local travel restrictions and the temporary closure of some beneficiary institutions during the early months of the pandemic delayed the distribution. Through September 30, 2020, 100.7 MT (67%) of the Harvest Lentil Pro® had been distributed. The remaining 33% (49.3 MT) of the product was distributed to beneficiary institutions from November