Friday, April 30, 2010

"Kids in poverty need escape velocity"

I had the opportunity last night to listen to my old friend Eric Schwarz, the founder of Citizen Schools, share his vision for the future of education in America with the Reynolds Fellows at Harvard.

Based on his frustration that we have a lower graduation rate today than a generation ago, and that we are not giving kids enough time to learn or enough talented adults in their lives, Eric founded Citizen Schools in 1995. It embodies the principles of sharing strength by creating opportunities for citizen teachers who want to give back and who in effect constitute a second shift of educators who create expanded learning time.

Understanding that “kids in poverty need escape velocity” Citizen Schools is committed to surrounding middle school students with all of the resources they need to have a truly transformational experience. They are hopeful that the Department of Education’s Invest in Innovation Fund will help fuel Citizen Schools next phase of growth. If you are trying to bear witness to what is needed in education today, check them out at

Tuesday, April 27, 2010

Polio, malaria, hunger and expensive failures of imagination

Last Sunday’s celebration of the third annual World Malaria Day was met with great optimism about the progress made in reducing deaths from malaria through insecticide treated bed nets and other measures. The number of African households with least one bed net increased from 17% to 31% between 2006 and 2008, and 9 of 45 malaria endemic countries have seen a 50% drop in cases.
But on Friday the Wall Street Journal led into the weekend with a cautionary tale in the form of a lengthy front page story, not about the newly energized global effort to eradicate malaria, but instead about the decades long struggle to conquer polio and the setbacks that world health organizations and Bill Gates have encountered in their strategy of massive vaccination campaigns.
The lessons they’ve learned, described below, may be invaluable to how we think about not only eradicating polio and malaria, but of ending hunger too.

The Journal article documented new polio outbreaks in a number of African countries – Uganda, Mali, Ghana, Kenya - that had been believed to have stopped the disease. Over the past two decades $8.2 billion has been spent to kill off polio, just as smallpox was eradicated in 1979. Bill Gates spent $700 million of his own on this over the past few years. Success seemed close. 350,000 cases of polio in 1988 decreased to under a thousand by the year 2000. But last year, new outbreaks brought the total back to 1600 cases. It was found that once polio was ended in some countries, weak health care systems, bad sanitation, and malnutrition, let it return.
The Journal framed the issue this way: “one of the most controversial debates in global health: is humanity better served by waging wars on individual disease like polio? Or is it better to pursue a broader set of health goals simultaneously – improving hygiene, expanding immunizations, providing clean drinking water – that don’t eliminate any one disease, but might improve the overall health of people in developing countries?”

Big donors usually prefer the “vertical” strategy of fighting individual diseases. The broader “horizontal” strategy is less specifically defined and might take many years longer with no fixed deadline. This week the Gates Foundation and allied organizations will announce a revamped plan that represents a major rethinking of strategy, “acknowledging that disease specific wars can succeed only if they also strengthen the overall health systems in poor countries.”

Bill Gates has an impressive track record of matching his big bank account with big ideas. But even he suffered a failure of imagination when it came to fighting polio. The enormous financial commitment made to the disease specific approach must have seemed like a leap of imagination in and of itself, perhaps the bolder course in the either/or choice described above. But bolder still is the now apparent need to do both, notwithstanding the pressure it creates on resources, focus, and ability to measure and celebrate results.

Our efforts to end childhood hunger will eventually face the same challenge. In the short-term there are many achievable victories to be had in closing the gap between those eligible but not enrolled in food and nutrition programs. But in the long term the best way to ensure that families have reliable access to nutritious food is to also tackle the related issues of education, economic opportunity, health care, etc.

Hunger no more exists in a silo of its own than does polio. Eventually the entire socio-economic ecosystem that causes it must also be addressed.

No one organization will ever be well enough resourced, or wise enough, to do all of that on its own. And so humility paves the path to collaboration. It’s another lesson worth remembering by the Gates Foundation, and all of us.

Wednesday, April 21, 2010

Adam Nadel's photographs bear witness to malaria's toll

Yesterday in New York I stopped by the United Nations to see a special photographic exhibit running through May 15 called Malaria: Blood, Sweat and Tears. The nearly 40 pictures were taken by 43 year old photo-journalist Adam Nadel. Fifteen of them can be seen at

The photos taken in Uganda, Nigeria and Cambodia are of those who either have the malaria or are engaged in fighting the disease in a variety of ways including as community health workers, a guard at a bed net warehouse, or an African pharmacist. Each picture is compelling on its own but when you consider them as a whole, and examine common features, you better understand what makes this photographer’s effort to bear witness so powerful.

Many of those photographed are outdoors, even when a house or building is in the background. That is probably for practical reasons having to do with sufficient light. But it also underscores the degree to which they live exposed and vulnerable, not episodically, but routinely, in an almost permanent state of jeopardy. Everything about their lives seems foreign and far away, distant and difficult. Children are barefoot on mostly dirt roads. Rooms are dark and all but empty.

The exhibition reveals the many connections between malaria, hunger and poverty. The disease is especially hazardous for those suffering from malnutrition which compromises one’s immune system by retarding the production of antibodies needed to fight the parasite. Also, a low fat diet inhibits the body from absorbing anti-malarial medications. As a result patients often spend what little money they have on an insufficient dosage.

I recognized one of the women in the photos. She is in her late twenties, with jet black hair and high cheek bones shining in the sun like polished apples. She is wearing a colorful flowered blouse and carrying her feverish son, with a green towel draped around his shoulders. They are outside, with a lush green hillside behind them, just slightly blurred.

From the way her body is angled it looks as though she may be balancing in the back of a truck. Her son’s chin is tucked between her left arm and breast and her strong left hand pressing against his back steadies him as they race toward their destination. His lower jaw is pulled slightly to the left, as if his teeth are chattering from severe chills. His eyelids are heavy, almost closed. But not her eyes. In fact they burn fiercely, not with fever but with frightened determination.

I recognize her even though we’ve never met. I recognize her because I can see from her urgency and selflessness that she is every mother I’ve ever known, acting on instincts encoded in genes millennia ago. She is the Philadelphia mother who shared her Witnesses to Hunger story at our Conference of Leaders, she is my wife Rosemary and sister Debbie, she is every mom who has worked at Share Our Strength,

The website says her name is Pheap Sung. She told the photographer that “He was sick for three days, had a very high fever. I would have sought help at a private clinic, but I did not have the money. The free clinic is a long way, but I decided I had to take him. I thought he might have malaria.”

If the clinic had been five times as far it would have made no difference. There is no such thing as too far, too much, too expensive or too complicated. There is no such thing as unreasonable when it comes to a mother doing what is necessary for her child.

The exhibition brings us images from thousands of miles away but if we look carefully enough it reveals not the distant and foreign but the intimate and familiar. The photos are a way of holding up a mirror that challenges our perceptions and call on our imagination.

In that way the photos succeed, at what Ophelia Dahl described in her Wellesley commencement address as “linking our own lives and fates with those we can’t see” affirming that “imagination will allow you to make the link between the near of your lives with the distant others”

We can’t all go to Uganda, Cambodia, or Haiti to witness suffering or to fully understand the need, opportunity and possibility. But if we are purposeful about using our moral imagination we shouldn’t have to.

In today’s world more than at any time in human history, we have access to all of the information needed for bridging that chasm between distant and near. The question is what we do with it, whether we not only analyze and categorize and think about it, but also let ourselves feel something about it and act on those feelings.

Monday, April 19, 2010

Overcoming Failures of Imagination

This weekend’s Global Health and Innovation Conference sponsored by Unite For Sight brought 2200 participants together from the fields of international development, public health, social entrepreneurship, medicine, microfinance and human rights, just to name a few. Speakers included Jeff Sachs, Seth Godin, Jacqueline Novogratz.

Much of the discussion centered on building sustainability and getting ideas that work to scale. As is often the case at such gatherings there was a focus on sharing best practices, measuring impact, and obtaining the necessary resources for success.

I took my opportunity to speak on Saturday morning to challenge the attendees to also look inward. Contrary to the conventional wisdom, the greatest cause of failure is usually not a failure of finances or strategy or execution, but rather failure of imagination.

Many of the most successful social entrepreneurs today represent triumphs of imagination more than anything else:

 Wendy Kopp’s idea that college graduates could be trained in a brief time and placed into some of the nation’s toughest schools was a triumph of imagination that led to Teach For America.

 Victoria Hale’s belief that there could be a nonprofit pharmaceutical when none had ever existed, was a triumph of imagination led to drug and vaccine development for neglected diseases through the Institute for One World Health.

 Steve Hoffman’s embrace of a malaria vaccine candidate that others had rejected as too difficult was a triumph of imagination that led to the creation of his biotech company Sanaria, in which the Gates Foundation invested nearly $30 million to produce what may be the world’s most effective malaria vaccine.

Imagination is not the same as creativity. It is more than an effort to improve on how things have been done in the past. Rather it is an effort to envision what has never before been done. It is an openness to not just the reasonable ideas but the unreasonable.

George Bernard Shaw once said: “The reasonable man adapts himself to the world: the unreasonable one persists in trying to adapt the world to himself. Therefore all progress depends on the unreasonable man”

There is much to be learned from the imaginations of unreasonable men and women.

Friday, April 16, 2010

bearing witness in a quiet workshop in Haiti

We returned to Haiti this week, on the three month anniversary of the earthquake, to try to keep some of the promises implicit in our first visit. Timberland CEO Jeff Swartz enabled us to bring a delegation that met with everyone from the Minister of Health to the World Food Programme. There’s more to tell than will fit here. Not all of it hopeful. But one moment was and because of your amazing friendship and support I wish you’d have been there to see it.
At a crowded intersection in downtown Port au Prince stands a building not damaged by the earthquake that is being used by Handicap International. In front, the chaos of Haiti’s capital plays out as cars race by and people swarm through the streets while others stand waiting for the packed, colorful minivans known as tap-taps. Inside the building it is also crowded but very, very quiet.

The first two rooms on the ground floor are unlit and dusty, with work tables and machines and electric cords snaking across the floor. A few lanterns hang from the ceiling. This is one of only two workshops in Port au Prince able to make prosthetic limbs for the several thousand new amputees recovering from the trauma sustained when crushed by falling buildings. A dozen artificial limbs in various states of construction are leaning against a wall, as if dancers on prom night taking a rest. Technicians at lathes stare at blueprints and specifications to ensure the next limb will fit the next body.

In the back is a sunlit open courtyard. Benches line the perimeter. There sit at least a dozen Haitians: men, women, boys and girls who have lost one or both legs in the earthquake. Some have family members with them who seem to hang back as if realizing that they will never truly understand what their loved one is going through.

An elderly woman in a green dress is being coaxed forward to take her first steps on her temporary prosthetic device. A somewhat angry young man in his early thirties is sitting and waiting for a technician. A beautiful dark haired girl of thirteen or fourteen sits in a clean red dress with her eyes cast down toward the ground as she gently rubs the jagged scar at the stump of her right leg. A young boy of about eight is in a chair and is having the below-the-knee stump of his leg eased into the soft socket of the artificial limb. He wears a Star Wars t-shirt whose bold logo suggests anything is possible though it is far from clear that he can share in such optimism. I don’t know his name but let’s call him Skywalker. More amputees sit in chairs waiting and staring into the distance.

Even before the earthquake Haiti had almost no capacity to handle rehabilitation after amputation. The technicians and therapists working with the patients are volunteers brought in from El Salvador, which is home to a prominent prosthetic training school. They speak neither the French nor the Creole spoken throughout Haiti. Their patients are having the most important conversations of their lives through pantomime and hand signals. But what they lack in language they make up in tenderness. One young therapist whispers something soothing to the girl whose face seems more stricken than her injured body. A volunteer from Australia gently taps Skywalker’s stump to probe for and be able to protect areas where he will feel the most discomfort.

I’ve come to visit with former Senator Bob Kerrey who lost a leg in Vietnam and has been active ever since in helping build prosthetic clinics in places that have none, and Winfried Danke, the executive director of the Prosthetics Outreach Foundation. Senator Kerrey is talking to the young man in his thirties and it is not clear that he is getting through to him. I see Bob do something I’ve only seen him do once in the 26 years we’ve been friends. He pulls up the cuff of his pant leg and shows the man that he too has a prosthetic limb. It’s not clear whether the gesture has its intended impact but across the room, the young girl who has been sitting sadly sees this out of the corner of her eye and becomes suddenly animated. Her hand shoots out, flutters and grasps to grab the attention of the therapist with whom she cannot speak. She points toward Bob, insists that the therapist look too, and for the first time that day her face breaks into a huge grin.

Meanwhile eight-year old Skywalker is being lifted up to take his first step since he was injured months ago. He is trying to be brave but he winces a bit with the pain of using new muscles. No less than four technicians are kneeling around him, one helping him balance, another assessing his step, another whispering encouragement. He tries again and his eyes fill with tears. There is bravery and determination in this once routine action that most of us take for granted. My memory flashes back to Neil Armstrong taking that first tentative step on the moon. I think about what a powerful a moment that was, and how it was nothing compared to this.

I’ll write again soon to tell you more about the conditions here and the progress we are making. Some problems, like those here in Haiti, are so complex that they almost defy response. They leave us feeling almost helpless and resorting to options that are not governmental but personal, not strategic but instinctual. They reinforce the often underestimated value of just a little tenderness. Mostly they remind us that of the numerous challenges that lie ahead, sometimes the greatest courage of all lies in taking that one first step.

Sunday, April 11, 2010

The Urgency of Bearing Witness

Because of the many ways in which we think about bearing witness, this article in the New York Times over the weekend caught my eye and I thought you might appreciate reading it as well. It is a poignant description of an 86 year old Holocaust survivor struggling to bear witness even as his memory fades.

One passage that especially resonated with our work at Share Our Strength, and that brought to mind the powerful Witnesses to Hunger project we supported and featured at our most recent Conference of Leaders, was this statement by Elie Wiesel: “I believe fervently that to listen to a witness is to become a witness.” Our opportunity and responsibility, through Hinges of Hope, our numerous events, travel to Haiti, our No Kid Hungry blog, etc. is to not only bear witness ourselves, but to create ways in which others become witnesses to.


The Urgency of Bearing Witness

Ernest W. Michel’s calligraphy skills helped save him from the gas chamber when he volunteered for a job requiring good penmanship. He ended up inscribing the death certificates of fellow inmates at Auschwitz.


Published: April 9, 2010

He has been telling the story for more than 60 years: expelled from school at 13 for being Jewish; arrested at 16; sentenced to labor in the service of Nazi Germany until an SS guard’s blow landed him, at 20, on the doorstep of death — an infirmary at Auschwitz.

Mr. Michel revisited Auschwitz when he turned 60.

Stefan Heyman, the prisoner-worker who helped save Mr. Michel by asking for a volunteer with good handwriting.

Good handwriting saved his life.