Malteser International promotes an integrated approach to sustainability, disaster risk reduction, and community health. Their programs in remote villages in Myanmar have strengthened health systems and made communities more resilient by training local health workers, building rural health centers, rehabilitating mangrove forests, protecting water sources, and constructing rainwater collection tanks. This integrated work empowers communities to respond to disasters and improves livelihoods. Lessons learned include considering all development work as contributing to resilience, advocating holistic programming with local authorities, and promoting community ownership through participation and organized village committees.

1. The Future of Sustainability and Disaster Risk Reduction
in Post-Rio+20 and Post-HFA:
Lessons Learned from the Field Level Program Implementation
Dr. Mel Capistrano, DRR Regional Adviser for Asia, Malteser International
In June of this year, at the Rio+20 conference the attending members reaffirmed their commitment to
Agenda 21 in their outcome document called "The Future We Want". Section 1 of Agenda 21 is about Social
and Economic Dimensions. It is directed towards combating poverty, especially in developing countries,
promoting health, achieving a more sustainable population, among others.
This section is of particular interests to Malteser International, since it is an organization that focus on the
nexus of health, water, sanitation & hygiene (in short WASH) and disaster risk reduction while it undertakes
development programs aimed to improve the quality of life of highly vulnerable communities and
marginalized groups.
With the advent of disasters and a changing climate, demands for health care services have been increasing.
This justifies even more the need for establishing and sustaining a community health system that can
strengthen the foundation of safety and reduce health risks, particularly of the most marginalized section of
the society. Sustaining a community health system for the poor is strategic to attaining the resilient
communities. It calls however for a more integrated and holistic approach that promotes people’s
participation in the management of their own health and other health related concerns.
Malteser International’s program in Myanmar, for example, promotes the integration of health, WASH and
DRR or CCA. Byrecognizing the links among the said sectors, the organization has developed and implemented
projects designed to strengthen health systems for resilient communities in very remote and hard to reach
villages.
The fundamentalsof CBDRR in the form of capacity building and preparedness are key in creating an
environment in which communities could mobilize and protect themselves during a hazardous event in order
to reduce their vulnerability. However, efforts were put towards building community capacity in enhancing
health service delivery provision and other concerns such as water supply protection, securing of buildings to
serve as evacuation centers, and improvement of knowledge towards behavior change in hygiene and
sanitation practices. With an integrated programming, the communities were able to develop a multi-sector
capacity that contributed significantly to better preparedness and improved ability to respond and recover
from disasters, thus to be more resilient in general
For example, by having trained health workers in the target community created an environment where
trained members residing in the vulnerable communities were able to respond to health complaints of people
during normal circumstances and prevented outbreaks of diseases greatly contributed to the general capacity
of the community. The same groups were also tasked to provide essential treatment to their community
during the aftermath of a disaster.This is in particular important in remote areas like in the border regions of
Myanmar where the governmental health system is not fully developed.
The construction of rural health centers provided benefits not only to the health sector but also contributed to
CBDRR by providing a safe location for communities to seek refuge during a cyclone. Moreover, these health
facilities were equipped with reinforced structures such as latrines and rainwater collection tanks so that water

2. supply and safe sanitation were available during times of emergency when communities locate there as part of
their evacuation plans.
Malteser International began a partnership with a local NGO to rehabilitate initially some of their former
mangrove forest areas. The mangroves protected the community from storm surge and partly from tsunamis.
Myanmar had faced significant degradation of mangroves over recent years. The primary cause of this comes
from the pressure of human settlement. Households collect wood from these areas and use it for cooking and
housing materials. In addition, the successful shrimp farming industry has also put pressure on these areas
and mangroves have been cleared to make way for the ponds in which they are grown. With the rehabilitation
of mangroves, livelihoods have improved through increased fish catch. The mangroves are not only important
as physical barriers but also for the livelihood, enabling the fishing community to be prepared for risks and to
aquire savings so that when there is a crisis, they are more resilient to carry the burden (usually financial)
associated with the hazard. This demonstrated the strong interlinkages between livelihoods and DRR,
reinforcing each other.
Through pond fencing and raising of embankments, the preferred community water supply source for drinking
water is protected not only from contamination by animals, but also from surface flooding that may result
from a meteorological hazard. By promoting the safety and maintenance of a primary water source,
communities could ensure that it remained useable after a disaster strikes, thereby offering a vital need
during the subsequent emergency phase.
Malteser International also constructed community rainwater collection tanks with a raised platform. These
structures provide much needed water supply that could be safely stored until the dry season when demand
was the highest, but also during the aftermath of a disaster. Tanks were constructed with fenced platforms
and stairs to offer a safe location for evacuation during a flood situation.
One lessons learned is related to programming CBDRR activities in relation to other development initiatives:
DRR tends to concentrate on natural hazards and to a certain extent this is true. However, all development
work is contributing to the resilience of the target communities and their capacity to cope and recover from a
hazard, whether it be economic, meteorology related or social. These commonalities should be considered in
order to offer a comprehensive solution to the development needs of a community.
Another lesson is to advocate the holistic programming with the local authorities during the initial stage of
project development. Support was provided with ease since they were consulted and engaged in the process
of designing the program.
The third lesson is related to the promotion of a sense of community ownership: Through various trainings,
local people were convinced the importance of their participation and effectiveness of the initiatives together
with their commitment. A special focus in mobilizing communities was to engage them in activities that
provided venues geared towards enhancing their problem solving skills. Also the organization of groups in the
community such as village development committee who were duly recognized by the local government and
other groups such as village health committees, mother support groups and water user groups will help
significantly in sustaining project initiatives. They were organized to identify community needs, prioritize these
needs and act appropriately on said needs.
Though we agree to the demand of Rio+20 to speed up the implementation of HFA in order to be sustainable
it needs to be done in a participatory and holistic way as described above. For this we need to give the people
time to understand and to organize themselves. They are busy with their daily survival and for any additional

3. engagement they need time. Malteser International is therefore requesting the donors to acknowledge that
and provide better conditions for the facilitating organizations. This is in particular necessary if we want to be
inclusive and take all people “on board”, especially the children, the elderly or people with disabilities.
At this point, let me end this talk by reading a poetry from a Chinese Philosopher named Lao Tzu. This poetry
had guided me personally in working with the community in very remote locations and mobilizing them to
ensure project initiatives: “Go to the people. Live with them. Learn from them. Love them. Start with what
they know. Build with what they have. But with the best leaders, when the work is done, the task
accomplished, the people will say "We have done this ourselves".”