Skip to content

The Magic Years: Care Groups

My grandson had a birthday recently. He’s two. He blew out candles, devoured cake and ice cream, and tore into presents. His favorite was a large bubble machine that floated huge translucent bubbles all over the room when he blew with all his might.

My work every day at World Relief involves birthdays. We mark them, celebrate them, prepare for them, and advocate for them. No, not birthdays with cake and bubbles, but birthdays with critical significance: the milestone of reaching a precious child’s fifth birthday.

The months of life in a mother’s womb and the first five years of a child’s life are the most critical. These are the years of rapid brain growth, physical, mental, and developmental growth, of early adaptation to our world of disease, of bonding with mother and family, and of discovering personhood, belonging, and identity. These are the “magic years” as described by author Selma Fraiberg. [1]

Too many children in our world never reach their fifth birthdays. In fact, nearly 6 million children under-five die every year. [2] They die prematurely from diarrhea, malnutrition, malaria or pneumonia; all of which are preventable deaths. Today, however, we know how to simply, cost-effectively and radically ensure that no child fails to reach his or her fifth birthday because of these causes.

Recognizing what nutrition experts call, a “Window of Opportunity” to promote nutrition and early development during the first 1000 days of life (counted from conception to two years), World Relief and the communities and churches we work through are seizing this opportunity to protect and nurture these precious children under the age of five. The interventions are basic:improved nutrition for mothers, infants, and children; prevention of life threatening pneumonia and diarrhea;and prevention and early treatment of malaria. Something as simple as hand-washing with soap can prevent persistent diarrhea that may eventually lead to severe dehydration, malnutrition and even death in a two-year old.

So what prevents this life-saving work from saving the lives of more children? How can we reach the millions of children needing this support throughout these early months and years? How can we impact behavior, especially where some cultural practices and a simple lack of knowledge can impede growth and development?

Long ago, a practical solution to reaching large masses of people was proposed by Jethro, a simple farmer whose son God chose to lead the Israelites to the Promised Land—Moses. Today, World Relief and many other NGOs and governments are using the same model Moses initiated…and we call them Care Groups.

Care Groups are an integral part of our Church Empowerment Zone (CEZ) model, pioneered in Rwanda and used across many of our programs in sub-Saharan Africa, and parts of Asia and the Middle East. As a part of the process, small groups of 10-15 community members are formed, trust is built, information is shared, volunteers support one another, and then share their learnings with neighbors in their village. Complete community saturation is the goal and the means through which Care Groups can potentially reach every child under five to ensure they safely navigate their early years.

The implementation and impact results of this biblically-designed approach has a growing amount of evidence-based findings. The peer-to-peer approach has reached over 1.4 million households in more than 28 countries globally. [3] It is attracting public health experts, government ministries of health, and large development funders. And, it is at the very core of what we do here at World Relief.

World Relief’s Pieter Ernst first developed the concept of Care Groups in 1995. In his words:

About 3,500 years back in history, a skilled and educated leader by the name of Moses from a nomadic nation of around 3,000,000 people wanted, on his own, to judge and resolve all the social and many other problems they had as a result of living so close together. Interestingly, in spite of all his education and his close relationship with God, he was unable to see beyond his own experience, and God sent his less educated father-in-law, Jethro, from a distant country to visit and advise him about the advantages of Care Groups. He also gave him some important selection criteria for choosing the right volunteers, and gave him guidance on an accountability that included a supervision structure that would help secure sustainability. Therefore, in reality, Care Groups is a design structure that is 3,500 years old. It is God’s doing… [4]

With a little updating from Moses’ time, today we are pressing our technological age to do what works, no matter how simple it may be. Public health experts who studied eight Care Group projects found that as a result of the group teachings and outreach, under-five mortality decreased by 32%. And the cost per beneficiary per year for such impact? Only US $3-$8. [5]

Once scaling and saturation takes place in communities, the Care Group model allows communities to reach a critical tipping point that has the potential to transform entire nations. As a result, the Care group model becomes an efficient, inexpensive, self-sustaining vehicle for transformation.

It is a future that is bright, and filled with healthy, joyful children, celebrating many more birthdays to come.

 

[1] The Magic Years: Understanding and Handling the Problems of Early Childhood (Fraiberg, Selma. Simon and Schuster.)

[2] Acting on the Call, USAID, 2017 Fact Sheet

[3] Global Health:  Science and Practice 2015, Vol 3, Issue 3, p. 370

[4] CORE Group Conference for Global Health Practitioners, Silver Spring, MD October 16, 2014, Acceptance Speech by Pieter Ernst for Dory Storms Award

[5] Global Health:  Science and Practice 2015, Vol 3, Issue 3, p. 370


Deborah Dortzbach is the Senior Program Advisor for World Relief. She has been involved in church-based HIV/AIDS prevention and care since the early 1990s. Prior to joining World Relief she directed MAP International’s HIV/AIDS programs from 1990-1997. Doborah is the author, with W. Meredith Long, of The AIDS Crisis: What We Can Do (2006), as well as Kidnapped (1975), which chronicles her 1973 abduction with her husband by the Eritrean Liberation Front while they were working as missionaries.

Transforming Lives and Communities Through the Local Church

For years governments and humanitarian organizations have poured money and effort into global aid. With the state of our world today, it’s no wonder people ask, “What has this accomplished? Is there a better way?”

Over seven decades, World Relief has operated in more than 110 countries alongside governments and other humanitarian organizations. Over these years, the successes and failures of our efforts have become clearer.

Humanitarian organizations bring essential emergency aid to those caught up in natural and man-made disasters. They make meaningful contributions to lifting people out of material poverty, reducing preventable diseases and increasing access to education.

However, too much of the public’s focus and money is consumed by crisis interventions and progress is rarely sustained after the initial response. And too often, interventions address only symptoms of vulnerability rather than root causes. They stop at the front door of the home and don’t address what goes on at a familial and relational level. Too often they lead to cultures of dependency, incredible waste, and even fraud and corruption. For all the progress, 1.3 billion people are still living in extreme poverty and—according to a recent World Bank report—these people are becoming far harder to reach.

World Relief believes there is an answer to these challenges. And it lies in engaging the local church and leveraging it to do what neither governments nor social enterprises nor multinational corporations are able to do.

The story of Dr. John Snow, the father of modern public health, is a most illuminative example. During the 1854 cholera outbreak in London, Snow became convinced that the disease was spreading through water contaminated by human waste, but he needed the help of local clergyman Reverend Whitehead to engage with the local community to map the households where cholera had occurred. This legendary collaboration reflected a shared commitment to the health and well-being of all people and an appreciation of the value of trusted relationships and community support in affecting change. It became the basis for modern-day epidemiology and pointed the way to the collaboration we so often need today.

Today—even with scientific and technological progress—the church still has a crucial role to play as it follows Jesus’s command to love “the least of these.”

Most people will remember the 2014 Ebola crisis in West Africa and the ripple of fear that went around the world. We all applauded the courage of medical workers who bravely served on the front lines and the work of scientists and doctors to develop a vaccine in record time. But less well known, perhaps, was the critical role that faith leaders played to complement and extend the impact of government and humanitarian aid organizations, convincingly documented in a 2015 Report, “Keeping the Faith” by Christian Aid, CAFOD, Tearfund and Islamic Relief Worldwide.[1]

In Liberia and Sierra Leone, the majority of the population are practicing believers, and faith leaders enjoy significant trust and respect. Unfortunately, there was a significant delay in engaging these leaders at the start of this most severe Ebola outbreak in history. As the disease spread, draconian measures were taken which went against cultural values and religious practices, resulting in a widespread public denial of the disease and even hostility towards those who were seeking to contain it. Many of those with Ebola chose to remain with their families and burials were undertaken in secret. As a consequence, the disease continued to spread. Government messaging on the cruel medical realities of Ebola spoke to people’s intellect, but did not create behavior change; rather, such messaging served to push care of the sick, as well as traditional approaches to burials, underground.

Later, once faith leaders became involved, they played a transformational role. Using religious texts, they preached acceptance of Ebola workers and survivors and role modeled this acceptance in religious services. They also helped to drive out the stigma that was destroying community cohesion. Where Ebola-control practices were considered irreligious, it was the participation of religious leaders alone that enabled an acceptance of the necessary changes to curb the spread of the disease.

The HIV/AIDS crisis provides another and perhaps even more compelling example of how critical it is to work with a deep respect for, and understanding of, traditional belief systems in order to impact sustained change. Twenty years ago, most people in Africa believed that AIDS was a plague from God and that it targeted sinners, who were merely “reaping what they had sown.” But then church leaders mobilized, and through the efforts of PEPFAR’s Track 1.0 AIDS Relief Program, they led their communities in reducing the demonization and stigma associated with the disease, encouraging care and treatment of HIV through voluntary testing, counseling and wide antiretroviral [ARV] distribution. Today 10 million people in Africa are on ARVs—a remarkable number when one considers that a mere 12 years ago there were almost no patients enrolled in official ARV programs. (For more details on the role of faith based organizations in combatting HIV/AIDS, see The PEPFAR Report, A Firm Foundation.[2])

Three attributes of church leaders make their influence in these situations particularly effective. First, they are highly motivated to support their communities and do so out of a spirit of compassion. Second, they usually have unparalleled access to, and knowledge of, their communities, especially in hard-to-reach areas where many of the world’s most vulnerable are concentrated. Third, they are trusted by these communities because of their moral voice and long-term presence and commitment. Unlike traditional NGOs, churches have no exit plan.

At World Relief, we truly believe the local church is God’s primary answer to the broken world, and his preferred plan to bring redemption—whether physical, spiritual or social—to his people.

Ephesians 3 states that “His purpose was that now, through the church, the manifold wisdom of God should be made known to the rulers and authorities in the heavenly realms.”

Through the church’s responses, we see God revealing his wisdom and redemption, pushing the darkness back. We are the hands and feet, but the power and the glory are his.

The same strengths that have made the church such a powerful force for good in the examples above do not stop there. Our experience convinces us that these same strengths, when properly harnessed, create a unique platform for the alleviation of poverty, for long-term community development, for the welfare of women and children, for peace and reconciliation, and for developing resilience to recurring disasters like drought and hurricanes.

Our experience convincingly demonstrates that long-term sustainable solutions are more likely to be truly transformative when we recognize the importance of local ownership and the unique position and moral authority of the local church; when we recognize that poverty is not just economic but that it takes many forms; when we recognize the crushing weight of despair and the power that comes with hope and the restoration of dignity; and when the church acts in unity to serve its community.

This is why the local church is at the heart of our theory and praxis of change. Not only because it is our calling, but because we have seen and been touched by the concrete evidence of its transformative power—physically, socially and spiritually—in our work around the world.

In Sub-Saharan Africa, where we are operating our innovative Church Empowerment Zone models, the impact of our work has multiplied throughout villages and even entire communities. We rely on the local church to carry messages concerning health, agriculture, savings, family strengthening, and child development to their neighbors. Our unique model empowers churches and their leaders to realize and fulfill their God-given potential to serve the most vulnerable in their communities, working collaboratively across tribal and denominational lines, and joining in unity with a common vision for their communities.

By building the capacities of church leaders and their congregations, and by enabling them to identify the unique needs and harmful beliefs in their communities, we ensure sustainable transformation comes from within and can multiply and expand once World Relief exits. In this way we are helping to move whole communities from despair to hope, from dependence to self-reliance, from broken relationships to thriving families, and from isolation and loneliness to shalom. We are also ensuring that the local church is not just a convenient delivery mechanism for our services, but the essential foundation of our work—pivotal in how we create real and lasting transformation that integrates physical, spiritual and social development, both individually and at the community level.

Of course, none of this undermines the importance of government and humanitarian NGOs.  In fact, public/private partnerships have never been more important given the multitude and scale of the challenges we face in the world today. And we need to stay open to collaboration with new social enterprises which bring much needed innovation to longstanding and previously intractable challenges.

Just as Dr. Snow and Reverend Whitehead discovered over 150 years ago, each of us have a role to play in seeking the well-being of all people, and we are stronger and better when we work together.

Over the coming months, we will be sharing a series of posts, entitled Perspectives, that demonstrate the extraordinary effectiveness of our Church Empowerment Zone model and how the principles that make it so powerful can also be applied to issues such as economic development, peace and reconciliation, disaster resilience, and maternal and child health, to name a few. These pieces will reveal that there are few other models capable of the kind of impact and leverage that we see when we harness the power and potential of the local church.

[1] Keeping the Faith (reliefweb.int)

[2] A Firm Foundation (pepfar.org)


Tim Breene served on the World Relief Board from 2010 to 2015 before assuming the role of CEO in 2016. Tim’s business career has spanned nearly 40 years with organizations like McKinsey, and Accenture where he was the Corporate Development Officer and Founder and Chief Executive of Accenture Interactive. Tim is the co-author of Jumping the S-Curve, published by Harvard Publishing. Tim and his wife Michele, a longtime supporter of World Relief, have a wealth of experience working with Christian leaders in the United States and around the world.

Changemakers in South Sudan — Establishing a Place of Peace and Love

This month, we’re sharing stories from our work around the world.  It is our hope that these stories will inspire, encourage, and enrich your lives. The following post was written by Darren Harder, Country Director for World Relief South Sudan.
 

“Let there be peace on earth, and let it begin with me;
Let there be peace on earth, the peace that was meant to be.

With God as our Father, brothers all are we,
Let me walk with my brother, in perfect harmony.

Let peace begin with me, let this be the moment now;
With every step I take, let this be my solemn vow

To take each moment and live each moment, in peace eternally.
Let there be peace on earth, and let it begin with me.”

The lyrics to this beloved Christmas hymn seem to ring truer with each passing year.

Peace. Something that has too often seemed unattainable in 2016. A year that has been difficult, contentious, and violent both here in the U.S. and around the world. A year that has challenged us all as individuals, as parents, spouses, friends, colleagues, even as Christians. Now, as we draw near to the end of the year, we long for a more peaceful 2017, one filled with love and with hope for a better tomorrow. 

Amidst this darkness, what better time to look to stories of incredible hope where peace can indeed triumph against the odds? Stories that encourage and inspire us. Stories that show us we can rise above our doubts. Stories like the one of the Church in war-torn South Sudan. 

Though pushed from international headlines by the tragedy of Syria and the horrifying images streaming almost daily out of Aleppo, few places have more tragic histories or precarious futures than South Sudan. After decades of civil war with North Sudan, the world’s youngest country was born to great fanfare and hope in 2011. But that hope did not last long. In 2013 violence broke out, between supporters of the President and former Vice President of South Sudan. Over the last three years, ethnic-based killings have taken place on all sides, accompanied by growing demands for vengeance. According to the U.S. Institute for Peace, nearly 4 million South Sudanese face severe food insecurity, and more than 2 million have been displaced by the war. 

The stories circulating in international media, paint a bleak picture of South Sudan and its immediate future. Even bleaker are the suggestions from the diplomatic community that the situation could get worse before it gets better. Despite multiple efforts to broker peace, South Sudan, like too many other places around the world, now faces impending catastrophe. Militias are mobilizing along ethnic lines, hate speech is circulating on social media, and international human rights groups are now documenting widespread human rights abuses.

And yet, against this dark canvas of suffering, fear, and forced displacement, one area stands out, determined to be a place of peace and love. This place is Ibba, a county in Western Equatoria State, where World Relief South Sudan is partnering with Church leaders, determined to become a light amidst the darkness.

In Ibba, World Relief is working in collaboration with local Churches to build homes for the elderly and the sick, run agricultural trainings to increase harvests in order to feed the hungry, and start savings groups. We are training women and young mothers in fostering peaceful family environments and in other life skills. Above all, we are focused on working together to organize spiritual activities that help build the unity of the Church, enable them to share each other’s burdens and challenges, and share in peaceful solutions. 

On November 20, 2016 a joint prayer service was held at St. Charles Lwanga Catholic Parish of Ibba, which brought together more than 3,000 people from across the region for over eight hours of prayer and worship. It was the first time that four Christian denominations, namely ECSS/S, Roman Catholic Church, Evangelical Lutheran Church, and Seventh Days Adventists, have come together to worship in Ibba. Church leaders preached messages of peace, unity, and collaboration. Many announced it was the first time in their lives that they’d seen such unity, and challenged the congregation to take the message of peace home to their neighbors.

As I watched the church come together as a unified body of believers, to pray for their communities and to serve the most vulnerable, I reflected on how much we can learn from our brothers and sisters in South Sudan who are doing the hard work of peacemaking each day.  Even though insecurity exists in neighboring counties, Ibba has remained calm, and I have no doubt it is due to the leadership shown by the local pastors in Ibba. I thank God for them daily and pray that they will continue to find their voice as they become beacons of light in their suffering communities.

Now and in the coming New Year, let us stand up for change. Let us join together with these peacemakers. Let us come alongside them to learn from them, to stand with them, and to give to them, so that they may increase their capacity for peace in South Sudan and beyond. Let us find peace on earth, and let it begin with you.

Changemakers in Rwanda — A Story of Light Overcoming Darkness

The following post was written by Moses Ndahiro, Country Director for World Relief Rwanda.
 

Rwanda.

A country as magnificent as it is complex. A place of breath-taking beauty, and of an unthinkably violent history. A marvelous land of a thousand hills, still haunted by an eerie morning fog that sits atop the horizon and whispers of horrors passed; a genocide that shook the world so deeply, it promised, “never again”.

It is a country unlike any other, where God’s creation is on display in all its splendor and diversity. The warmth and hospitality of a people striving to rebuild and rewrite their story. The hope of a history overcome, and of a nation reborn.

And it is a country where God is at work in powerful ways. Where people’s hearts and minds are being transformed through Christ. Where the Church is stepping into its rightful place as the hope of the world. 

It is a story of light overcoming the darkness.


The Church established itself in Rwanda over 100 years ago, and today, more than 70% of the population is in a church building every week. How then, in 1994, did a genocide of such horrific proportions and unprecedented brutality take place? Volumes have been written on the underlying causes, on the immediate events leading up to the genocide and of the failure of the world to take heed of the warning signs. Little, however, was said of the failure of the Church to stand up and protect the vulnerable. Fortunately, that has changed. Today’s Church in Rwanda is quite different from the institutionalized Church of the past. It is vibrant, diverse, and growing. And step-by-step, it has begun to walk alongside its people in their journey from darkness and despair, towards hope and renewal.

World Relief first established its presence in Rwanda immediately following the genocide. Watching the international community respond with one-off emergency interventions, we became increasingly convinced that solutions needed to center on the resourcefulness and hearts of the local people, and that the Church had a unique role to play. Born out of that conviction, World Relief first pioneered its Church Empowerment Zone model in 2011. Founded on our strong belief that transformational change begins with the Church, we began teaching, mobilizing, and empowering local churches and their networks to serve the most vulnerable in their communities. Through sharing and building leadership capacity, we brought churches of all denominations together in one network to unite under a common curriculum and leadership development program, giving them the opportunity to wrestle with common problems, share resources, and join together in a common vision for their churches, families, and communities.

“We do not see one another as enemies anymore. Now we come together as brothers, bringing our strengths together. We are at peace.” – Pastor Museveni

Today, the Church Empowerment Zone model is unleashing the potential of hundreds of churches and communities across Rwanda, building a legacy of hope, generosity, and self-reliance that is sustaining progress. Local churches are no longer simply institutions for Sunday gatherings, but the epicenters of their communities—transforming hearts, minds, and attitudes. Rwanda is a vivid and timely reminder that there is more to religion than just turning up to church. It has revealed how essential it is for our faith to be strongly rooted in a holistic and meaningful understanding of the Gospel. 

One pastor in Bushenge, Rwanda said, “Now we are caring for the poor and most vulnerable. We are creating love where the Devil was bringing hate and division. We are bringing the Kingdom of God down to Earth. Our families are in harmony. And a family in harmony will prosper in everything.”

Over the last five years, we have seen families reunited and health and nutrition outcomes improved. We have seen neighbors, siblings, spouses, children, and friends overcome their challenges and experience renewed and strengthened holistic relationships.  We have seen the transformation of lives.

The story of the church in Rwanda is powerful and inspiring. But it is not the only nation where the church is catalyzing transformational change.

Now is the time for the U.S. church to join in this rebirth. We have a unique role to play in helping African churches increase their capacity, and they have much to teach us about what it means to truly trust in God. When we work together in harmony, uplifting one another, and placing God at the center of our partnership, we have the true potential to transform the lives of millions of vulnerable people.

South Sudan: Where the Spirit of the Lord is, there is freedom

Independence. Just four short years ago, the people of South Sudan voted to break away from the north and form their own independent nation with the hope of a fresh start. Finally free from their opponents in the north, they could now look forward to a better future.

But freedom is not the reality that the people of South Sudan have come to know.

While the people of South Sudan became citizens of a new country in 2011, they could not escape conflict for long. Before South Sudan became its own country, the Sudanese in the north and south expressed differing political, economic and religious views.

Four years later, the people have, once again, found themselves in the midst of conflict. This time, the president and vice president are vying against each other for power – inciting ethnic differences to mobilize fighters around the country. After nearly a year and a half of calm, the renewed fighting has left tens of thousands of people in need of protection, basic provisions such as shelter materials, cooking supplies, food items and peace. Though another Independence Day has passed, it’s important to consider the reality of the situation in South Sudan.

After 17 years, World Relief’s efforts continue despite intensifying conflict, evacuations and the loss of two staff members. Our teams, as well as those of other organizations working in the region, have had to take a step back and reevaluate our work. But, we continue to provide emergency health, nutrition and safe-child programming while we distribute food and essential goods in Unity State.

In Western Equatoria State, which has been more peaceful, we’re taking a groundbreaking approach. This year, church leaders across denominations began to meet together to serve their communities with their own resources. These pastors have great hope that their churches can be a foundation for change and peace in South Sudan.

At World Relief, this is our hope as well. The people of South Sudan are still facing great adversity, but our God is faithful. We continue to work and pray, believing that South Sudan will come to know true freedom like Jesus promises.

On July 9 South Sudan celebrated its Independence Day. While we realize the tremendous challenges that still lie ahead, we celebrate the independence they have now and the freedom that is to come.

Let’s remember the words of Paul in 2 Corinthians 3:17: “Now the Lord is the Spirit, and where the Spirit of the Lord is, there is freedom.” God’s presence is real and active in South Sudan, and he is our ultimate hope for true freedom.

Since 1998, World Relief has responded alongside the local church in South Sudan. Through disaster response, agricultural development and health programs, we’re laying the foundations for lasting peace.

You can join us today as we continue to provide emergency food and medical supplies to the people most affected by the unrelenting conflict.

 

 

Site Designed and Developed by 5by5 - A Change Agency