Author: MIL-OSI Publisher

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Environment – ‘Nitrate emergency starts here’: Greenpeace pins blame on Canterbury dairy conversions

Source: Greenpeace

‘The Nitrate Emergency: it starts here.’ That’s what a freshly-installed Fonterra farm sign said outside Canterbury’s first complete dairy conversion this morning. Greenpeace installed the modified Fonterra sign saying that there can be no new dairy expansion in a nitrate emergency.
Greenpeace spokesperson Will Appelbe says “The dirty dairy industry, led by Fonterra, is responsible for Canterbury’s drinking water crisis. The nitrate emergency starts here – on Fonterra dairy farms just like this one, that contaminate drinking water with cow urine and fertiliser runoff.
Greenpeace’s sign was installed outside a controversial Wongan Hills dairy conversion in the Kaituna Valley, which the organisation believes is the first operational conversion in Canterbury this year.
“There can be no more dairy expansion in a nitrate emergency,” says Appelbe. “There are simply too many cows on the Canterbury plains and we can’t afford to add any more. New Zealand needs to reduce the dairy herd size, not grow it.
“Runoff from this dairy conversion will end up downstream in the Kaituna River, and then flowing into Te Waihora – already one of the most polluted lakes in Aotearoa.”
Studies show that regions of intensive dairying in Aotearoa have high rates of nitrate contamination – which is linked to several health risks. A prominent Danish study indicated that long-term exposure to levels of nitrate as low as 1 mg/L may be linked to an increased risk of bowel cancer, while other studies have linked levels of nitrate at 5 mg/L or higher to an increased risk of pre-term birth.
A recent groundwater study by GNS Science indicates that more than 100,000 people in New Zealand may be exposed to nitrate at 5 mg/L or higher – predominantly in rural areas like Canterbury.
“Everyone has the right to safe healthy drinking water but right now, many families in rural New Zealand can’t drink the water from their kitchen tap without fear of getting sick – particularly in Canterbury,” says Appelbe.
Greenpeace is calling on Cantabrians to vote for fresh water in the upcoming local elections. Appelbe says aspiring councillors have been put on notice.
“Environment Canterbury has declared a nitrate emergency, but there is so much more to do. Incoming ECan councillors must be prepared to put their money where their mouth is. It’s time to put an end to dairy expansion and phase out the use of synthetic nitrogen fertiliser – because safe, healthy drinking water is a fundamental human right.
“Fonterra CEO Miles Hurrell held a press conference about the extortionate price of butter. When will he front up to the people of Canterbury for causing the nitrate emergency?”
Notes:
  • Environment Canterbury issued the Wongan Hill’s farm with effluent discharge consents in January, which enabled the conversion to intensive dairying. The farm can milk up to 800 cows a day, with 400 cows wintering in a composting feed barn.
  • The intensive dairy farm is located next to the Kaituna River which flows into Te Waihora.
  • Kaituna River has been identified as a site of cultural and ecological significance. It provides important habitat for indigenous birds and freshwater fish. It supports two bird species that are nationally Threatened (Australasian crested grebe and Pied cormorant), and one that is nationally At Risk (Black cormorant). It is distinctive as one of only two lowland rivers in New Zealand where Australasian crested grebe are known to breed.
  • Te Waihora is a living shallow, brackish coastal lake-lagoon that is nationally and internationally significant for its cultural and ecological values. It is also one of New Zealand’s most polluted lakes.
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Agriculture – New movement restrictions boost Otago’s bovine TB protection

Source: OSPRI New Zealand

Disease eradication agency OSPRI’s introduction of a new Movement Control Area this week adds to initiatives already underway in Otago to eradicate bovine TB.
Restricting the movement of livestock is intended to be a precautionary measure, limiting disease spread.
The number of infected herds in the region has reduced recently to five in Otago – four beef herds and one deer. There are 16 infected herds across New Zealand.
“Otago, and central Otago in particular, is considered a hot spot for bovine TB because of the spread of the disease within the possum population in the area,” says Simon Andrew, OSPRI’s general manager of disease control planning and integration.
The possum is bovine TB’s main ‘vector’ or disease carrier.
“The movement control area we started from 1 October protects 110 farms within this region but also farms in surrounding disease-free regions.
“Other work we have underway in the area includes the assessment and scheduling of follow-up TB testing for animals which have grazed in TB risk areas.
“We have completed all the additional follow-up testing of animals which may have been in contact with those from currently and previously infected herds in the area.
“More than 1200 additional tracing tests have been completed in the area so far this year,” Simon says.
Earlier this year an aerial 1080 possum control operation was successfully delivered in the Clutha region.
OSPRI is also increasing its wild animal control and survey programme for the 2025/2026 year, including additional possum control in the South Waitaki.
“Our possum control and wild animal surveying for the next financial year in Otago will cover 507,065 hectares. Just under 120,000 hectares will be in the South Waitaki.
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Advocacy – New Zealand Activists Abducted – PFNZ

Source: Palestine Forum of New Zealand (PFNZ)

The Palestine Forum of New Zealand expresses its deep alarm and outrage at the abduction of Rana Hamida, Samuel Leason, and Youssef Sammour. These three New Zealanders, committed to justice and human rights, have been unlawfully taken while engaging in peaceful advocacy for Palestine.

Their abduction is a grave violation of international law and human rights principles. It is an attempt to silence voices of solidarity and to intimidate those who stand against injustice.

We call on the New Zealand Government to take urgent and decisive action to ensure the immediate and safe release of Youssef, Rana, and Samuel. As citizens of this country, their protection and freedom must be a matter of the highest priority.

We further urge the international community to join in condemning this abduction and to hold those responsible accountable. The world cannot remain silent while peaceful activists are targeted for standing up for justice.

The Palestine Forum of New Zealand stands firmly with Youssef, Rana, and Samuel, and with all who are unjustly detained for their commitment to freedom and human dignity.

They must be released immediately.

Palestine Forum of New Zealand

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Health – KEYTRUDA® (pembrolizumab) for certain patients with high risk early-stage triple negative breast cancer (eTNBC) now on Pharmac’s waitlist

Source: Merck Sharp & Dohme (New Zealand)  (MSD)

Auckland, New Zealand, 3 October 2025 – October is breast cancer awareness month, and Merck Sharp & Dohme (New Zealand) Limited (MSD) (tradename of Merck & Co., Inc., Rahway, N.J., USA (NYSE: MRK) is pleased to share that KEYTRUDA, an immunotherapy medicine for the treatment of certain patients with high-risk early-stage triple negative breast cancer (eTNBC), has been added to Pharmac’s Options for Investment list, (OFI) meaning it can be considered for public funding. 1

MSD Director, Vanessa Gascoigne, says, “The inclusion of KEYTRUDA for eTNBC on Pharmac’s OFI list is good news, and we are pleased to announce this, during Breast Cancer Awareness month. 1

“TNBC, which accounts for approximately 15% of all breast cancers, is an aggressive type of invasive breast cancer that tends to grow and spread faster than other types of breast cancer and has a poorer prognosis. 2,3 TNBC has fewer treatment options compared to other types of breast cancer as it lacks receptors that can be targeted by medications such as hormone and HER2-blocking drugs.2

“KEYTRUDA has been funded for certain patients with advanced triple negative breast cancer since October 2024, and we are now working with Pharmac, trying to extend funded access for certain people diagnosed at an earlier stage of this challenging disease.” 4

Breast Cancer Foundation NZ Chief Executive, Ah-Leen Rayner, added: “New Zealanders with high-risk early-stage triple-negative breast cancer need funded access to more treatment options. We hope Pharmac can widen access to KEYTRUDA so that eligible Kiwis with this aggressive type of breast cancer can have funded access to another treatment option.”

Vanessa Gascoigne, MSD New Zealand Director, adds “As of September 29th there are 122 other medicine applications on the Options for Investment list, waiting to be funded. 1 We will continue to work closely with Pharmac to try and progress this application for funding Keytruda for certain patients with high-risk early-stage TNBC.”

Consumer Mandatories

KEYTRUDA® (pembrolizumab) is available as a 100 mg/4 mL concentrate for solution for infusion.

KEYTRUDA is a Prescription Medicine and may be used in certain adults:

  • After surgery to remove melanoma, non-small cell lung cancer or renal cell carcinoma to help prevent the cancer from coming back
  • Before surgery to treat non-small cell lung cancer or triple-negative breast cancer and then continued after surgery to help prevent the cancer from coming back
  • To treat bladder cancer which has not spread to nearby tissues but is at high-risk of spreading and where bladder removal is not preferred
  • To treat the following types of advanced cancers: melanoma, non-small cell lung cancer, malignant pleural mesothelioma (MPM), classical Hodgkin lymphoma (cHL), urothelial carcinoma, head and neck squamous cell carcinoma, renal cell carcinoma, gastric or gastroesophageal junction adenocarcinoma, oesophageal carcinoma, cutaneous squamous cell carcinoma, cervical cancer, endometrial carcinoma, triple-negative breast cancer,  merkel cell carcinoma (MCC), biliary tract carcinoma, or a kind of cancer that can occur anywhere in the body, including the colon or rectum, and is shown by a laboratory test to be microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR).

KEYTRUDA may be used to treat certain children with MPM, cHL, MCC, or MSI-H/dMMR cancer. It is not known if KEYTRUDA is safe and effective in children with MSI-H or dMMR cancer of the brain or spinal cord (central nervous system cancers). Children may also receive KEYTRUDA after surgery to remove melanoma.

KEYTRUDA can cause your immune system to attack normal organs and tissues in any area of your body and can affect the way they work. These side effects can sometimes become life-threatening and can lead to death. These side effects may happen anytime during treatment or even after your treatment has ended. You may experience more than one side effect at the same time.

KEYTRUDA can cause some serious side effects. Serious side effects may include: lung problems, intestinal problems, liver problems, hormone gland problems, blood sugar problems, kidney problems, skin problems, problems in other organs and tissues, infusion reactions that can sometimes be severe, rejection of a transplanted organ or tissue, and complications in people with a bone marrow transplant that uses donor stem cells (allogeneic). These are not all of the signs and symptoms of immune system problems that can happen with KEYTRUDA. Getting medical treatment right away may help keep these problems from becoming more serious.

You should not be given KEYTRUDA if you are allergic to pembrolizumab or to any of the other ingredients.

If you are pregnant, think you may be pregnant or are planning to have a baby, tell your doctor. KEYTRUDA can cause harm or death to your unborn baby. You must use effective contraception while you are being treated with KEYTRUDA and for at least 4 months after the last dose of KEYTRUDA if you are a woman who could become pregnant. Do not breastfeed while taking KEYTRUDA.

Very common side effects of KEYTRUDA include diarrhoea, nausea, itching, rash, joint pain, back pain, feeling tired, cough, patches of discoloured skin, stomach pain, decreased levels of sodium in blood, and low levels of thyroid hormone.

The side effects listed below are additional common side effects that may occur when KEYTRUDA is given together with another treatment, in addition to the very common side effects listed above.

With chemotherapy or chemotherapy + radiotherapy: hair loss, vomiting, decreased number of red blood cells, white blood cells and platelets in the blood, mouth sores, fever, decreased appetite, and swelling of the lining of the digestive system (for example mouth, intestines).

With axitinib: high blood pressure, decreased appetite, blisters or rash on palms of your hands and soles of your feet, increased liver enzyme levels, hoarseness, and constipation.

With lenvatinib: high blood pressure, decreased appetite, vomiting, weight loss, headache, constipation, hoarseness, urinary tract infection, stomach-area (abdominal pain), blisters or rash on the palms of your hands and soles of your feet, protein in your urine, increased liver enzyme levels, and feeling weak.

In children, common side effects of KEYTRUDA include fever, vomiting, headache, stomach pain, decreased number of red blood cells, cough, and constipation. (v59)

These are not all of the possible side effects of KEYTRUDA. If you have any side effects, talk to your doctor.

KEYTRUDA has risks and benefits. Talk to your doctor about whether KEYTRUDA is a suitable treatment option for you. For more information about KEYTRUDA refer to the Consumer Medicine Information available at www.medsafe.govt.nz/consumers/cmi/k/Keytruda.pdf  

KEYTRUDA is funded to treat certain patients with the following cancers: melanoma, non-small cell lung cancer, MSI-H or dMMR colorectal cancer, triple-negative breast cancer, head and neck squamous cell carcinoma, urothelial carcinoma, and cHL. Patients must meet specific criteria to qualify for funding.

If KEYTRUDA is not funded for your particular cancer, you will need to pay the full cost of the medicine and its administration. Talk to your doctor about whether you qualify for funding, the cost of the medicine, and any other fees that may apply.

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Employment and Health – Mental health workers say they’ve had enough – vote to strike on 23 October – PSA

Source: PSA

More than 3,500 mental health and public health nurses and mental health assistants have voted to strike for 24 hours on Thursday 23 October in support of their claim for better pay and conditions.
The workers, who are PSA members, voted overwhelmingly to take strike action following the failure of Health NZ Te Whatu Ora to meet their concerns about safe staffing levels and make a pay offer that reflects their value to the health system. They have been bargaining for the past year.
The strike will run from 7am Thursday 23 October to 6.59am Friday 24 October.
They join more than 11,500 Allied Health workers who are striking from midnight to midnight on 23 October.
“The Government must fund health services properly, so that workers have enough money to live on and can continue to help New Zealanders facing challenges,” said Fleur Fitzsimons, National Secretary for the Public Service Association Te Pūkenga Here Tikanga Mahi.
The members are registered mental health nurses and public health nurses – including those working in community and in-patient areas, and mental health assistants who work in in-patient units and in some areas in the community.
“These nurses and mental health assistants work in some of the most demanding parts of the public health system, yet after bargaining for a year, their concerns about staffing levels and fair pay have fallen on deaf ears.”
PSA delegate and community mental health nurse Monique Larsen said the strike action is as much for patients and their families as it is for frontline workers.
“We can’t keep going the way we are now. We’re constantly trying to look after patients with absolute minimum levels of staffing – it’s not sustainable.
“We nurses and mental health assistants are reluctant to do this, but we’ve run out of patience with Health NZ and the Government.
“Our communities’ mental and public health needs have increased significantly post COVID – the impact post-pandemic has been overlooked. We’ve seen a massive increase of drug and addiction issues putting heaps of pressure on our mental health and addictions and ED services.
“We’re really worried about the whaiora who will slip through the cracks if we don’t properly resource services now and look after our existing and future healthcare workers. At current levels, we’re putting the health of our patients at risk.”
PSA delegate and registered mental health nurse Roy Bicknell said the nurses have been at the bargaining table for over a year with little to show for it.
“We don’t take industrial action lightly – we have patients relying on us for help. But when Health NZ has repeatedly refused to meet us on key health and safety issues, we don’t see any other option.
“Every day I see staff battle to provide quality healthcare in unsafe working environments, with few policies or procedures to support them. We want Health NZ and the Government to listen to workers and understand the real issues here and then commit to properly funding the healthcare system so we can all benefit.”
Fleur Fitzsimson said; “If these essential health workers are not properly valued, more will leave for Australia – that doesn’t serve anyone well.” 
The Public Service Association Te Pūkenga Here Tikanga Mahi is Aotearoa New Zealand's largest trade union, representing and supporting more than 95,000 workers across central government, state-owned enterprises, local councils, health boards and community groups.
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Household living-costs price indexes − update


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Price index methods – updates for the September 2025 quarter – Stats NZ methods paper


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Advocacy – New Zealand government urged to demand Israel release humanitarian boats to Gaza – PSNA

Source: Palestinian Solidarity Network Aotearoa (PSNA)

 

PSNA is calling for the New Zealand government to demand Israel release the activists kidnapped from the global flotilla in international waters and allow them to sail to Gaza with humanitarian aid for the people under Israel’s genocide.

 

There are four New Zealand activists in the group of ships intercepted by Israel and some have been kidnapped by Israel already from boats in international water.

 

These New Zealanders represent the absolute best of our country – taking part in an aid mission to millions of people suffering a genocide in Gaza.

“Our government must stand beside them and insist their humanitarian mission must continue”

 

“Our government has failed to hold Israel to account for genocide but it can stand by other New Zealanders and demand Israel allow them to deliver aid to Gaza.

 

Bianca Webb-Pullman  

New Zealander Bianca Webb-Pullman (a medical doctor) is on the flotilla and the boat she is on (the “Florida”) has been rammed by an Israeli naval vessel. Bianca has thrown her phone overboard and the boat is on its way again. 

 

Media can speak with Bianca’s partner Stephen Rowe in Raumati South on 0211177379.

 

Rallies around NZ

Various events are being held around the country including a rally in Ōtautahi/Christchurch at 5pm at the Bridge of Remembrance this evening (see poster below) where large posters will identify our political leaders who are complicit with genocide.

 

John Minto

Co-Chair PSNA

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Advocacy – Global Sumud Flotilla Amnesty International Statement

Source: Amnesty International Aotearoa New Zealand

Amnesty International STATEMENT
02 October 2025 – In response to reports that Israeli forces have intercepted the Global Sumud Flotilla and detained peaceful protestors, including three New Zealanders, attempting to deliver urgently needed food, medicine, and humanitarian supplies to Palestinians in Gaza, Amnesty International Aotearoa New Zealand’s Executive Director, Jacqui Dillon, said:
“The complete absence of any remotely adequate response from governments, including New Zealand’s, to Israel’s genocide against Palestinians has forced activists from across the world to take peaceful measures to break the siege.
Our Government must act. Their job is to immediately condemn this interception, demand the immediate and unconditional release of all those on board, including any New Zealand nationals, and insist that Israel ends its unlawful blockade and allows unrestricted humanitarian access to occupied Gaza. Anything less risks complicity in Israel’s grave violations of Palestinians' rights.
The New Zealand Government must do all it can to end this genocide. The atrocities must end.”
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Advocacy: Oxfam – Palestine recognition must come with action: to save lives, States must stop Israel’s crimes and ensure Palestinian agency

Source: Oxfam Aotearoa

Statement by independent groups
Most countries recognize Palestinian statehood, yet Israel’s international law violations are accelerating, with near-total impunity, causing mass displacement, widespread death, and an escalating humanitarian crisis throughout the occupied Palestinian territory . For real impact and to avoid complicity, States must turn their expressions of solidarity into concrete, life-saving action, and any plans for a way forward must place Palestinians as the main architects of their own future.
Statehood recognition is an important, welcome step in the realization of the Palestinian people’s right to self-determination. It cannot remain symbolic or be treated as a reward. Importantly, it doesn’t absolve Member States of their legal and moral obligations to put an end to the Israeli occupation in the occupied Palestinian territory (Gaza and the West Bank, including East Jerusalem) – which the International Court of Justice has determined to be illegal and in violation of Palestinians’ right to self-determination – and to stop what the UN Commission of Inquiry has determined to be a genocide carried out by Israel in Gaza.
The escalating humanitarian crisis driven by these actions is widely known and documented. Just in the past two years, Israeli eviction orders, demolitions, blockages, arbitrary arrests and direct attacks on people, have triggered the largest forced displacement in the West Bank, including East Jerusalem, since the start of the occupation in 1967. The largest land theft in three decades was officially approved last year, and violence by settlers is at an all-time high. In Gaza, Israeli authorities have been carrying out a deadly military operation that has killed or injured over 136,000 people, forced 2 million people to flee several times, and destroyed 90% of the buildings. Throughout Gaza and the West Bank, including East Jerusalem, Israeli forces have attacked health facilities close to 1,650 times. They have restricted free movement – through military checkpoints, gates, barriers, corridors and no-go zones – with devastating consequences on communities’ ability to access livelihoods, medical care, education and other vital services.
World leaders cannot claim ignorance. Even as 4 in 5 countries globally recognize the State of Palestine, the Israeli parliament recently approved a motion to completely annex the West Bank including East Jerusalem, where 3.3 million Palestinians live, and Israeli officials have reiterated their intention to pursue “complete sovereignty” over the West Bank, stating that “there is no Palestinian people and no Palestinian State” and that “the place belongs to [Israelis]”. Similar intentions have been openly declared for all of Gaza.
Such declarations are no longer fringe: they show what is driving the accelerated erasure of a people. Israel’s fragmentation and annexation of land internationally recognized as Palestinian is rendering the prospect of a viable Palestinian State less and less realistic.
Acting is not optional. The International Court of Justice clarified in July 2024 that all UN Member States are obligated to not recognize or support Israel’s unlawful occupation, including through trade and investments. Moreover, the UN Commission of Inquiry has determined that all States must “take all necessary steps to try to avoid or stop the commission of genocide”.
Just in the few weeks that have passed since several additional countries recognized the State of Palestine, hundreds of Palestinians have been killed and more than 1,500 have been injured by Israeli fire across the occupied Palestinian territory. The military takeover of Gaza City has accelerated in scope and brutality: deadly strikes on tents, housing units and public buildings have forced tens of thousands to flee once more, though most people have nowhere to go; several health care facilities in the north have had to shut down leaving hundreds of thousands with very limited access to medical care. In the West Bank, including East Jerusalem, settler attacks and military incursions and arrests have intensified. Dozens of Palestinian structures have been demolished. The Israeli parliament’s National Security Committee has advanced discussions to restrict humanitarian access to prisons where over 9,500 Palestinians are held as well as a law to authorize the death penalty for detainees.
With each hour of delay, another family is shattered, another child starves, another home is reduced to dust, another piece of Palestinian life is erased.
To avoid the outcome of having a State of Palestine without Palestinians, and to prevent Israeli forces and settlers from taking additional punitive action against communities, States must use every available political, economic, and legal tool at their disposal for:
  • An immediate and permanent ceasefire in Gaza, and for Palestinians to own and lead their own (re)construction plans and process, in line with their inalienable right to self-determination
  • An end to Israel’s illegal occupation of the entire occupied Palestinian territory, ensuring the conditions needed for Palestinians to stay in their land
  • Unrestricted UN-coordinated humanitarian access and protection, as enshrined in international humanitarian law, throughout the occupied Palestinian territory
  • An end to trade with illegal settlements, including the provision of services and investments
  • An immediate halt to all arms sales and transfers to Israel
  • Accountability for crimes committed
  • The immediate reopening of a corridor linking Gaza and the West Bank, including East Jerusalem, for medical evacuations and other purposes.
Endorsed by (alphabetical order):
  • 1. ActionAid International
  • 2. Al Awda Health and Community Association
  • 3. American Friends Service Committee (AFSC)
  • 4. Arab Educational Institute – Pax Christi Palestine
  • 5. Bystanders No More
  • 6. Churches for Middle East Peace (CMEP)
  • 7. CIDSE – International Family of Catholic Social Justice Organisations
  • 8. Emmaus International
  • 9. Global Centre for the Responsibility to Protect
  • 10. Global Legal Action Network (GLAN)
  • 11. HelpAge International
  • 12. Insecurity Insight
  • 13. Médecins du Monde International Network (MdM)
  • 14. Norwegian People’s Aid
  • 15. Oxfam International
  • 16. PARC – Agricultural Development Association
  • 17. Pax Christi International
  • 18. Palestinian Institute for Climate Strategy (PICS)
  • 19. Plateforme des ONG françaises pour la Palestine
  • 20. Sabeel-Kairos UK
  • 21. The Middle East Children's Alliance
  • 22. Terre des Hommes Italy
  • 23. United Against Inhumanity
NOTES
  • In 2025, Israeli policies and practices have forced at least 40,000 Palestinians out of their homes in the northern West Bank – all-time high since Israeli occupation began in 1967 – due to Israeli-ordered demolitions, evictions, and increasing attacks by settlers and armed forces. Another 66,800 at least face a direct risk of forcible transfer, as about 663 km 2 of West Bank land is vulnerable to settlement takeover and expansion.
  • Israeli authorities have approved the largest land theft in the West Bank in three decades in July 2024, as well as the construction of over 15,000 units and 22 new illegal settlements in 2025 alone, and established over 121 new outposts. Weeks ago, Israeli authorities gave final approval for the “E1” settlement project, which is effectively cutting off East Jerusalem from the occupied West Bank and further fragmenting the land.
  • For two years, Israeli forces have bombed Gaza relentlessly. The military operation has killed at least 66,000, injured 170,000 and forced close to 2 million people to flee repeatedly. Over 92% of housing units and 90% of school buildings are now destroyed and only 1.5% of cropland is now usable as a result.
  • Since 2007, Israeli authorities have blocked the entry of vital goods into Gaza, including an 11-week complete siege this year that has led to extreme starvation, with famine confirmed in northern Gaza, and severe shortages in health facilities.
  • Israeli forces have attacked health care facilities close to 1,650 times across the occupied Palestinian territory since October 2023.
  • Israeli authorities have imposed countless movement restrictions across the occupied Palestinian territory in the form of militarized corridors, checkpoints and no-go zones in Gaza (82% of the land is now inaccessible), and over 800 gates, checkpoints and barriers in the West Bank, including East Jerusalem, with devastating consequences on people’s ability to access livelihoods, health care, education and other vital services.