Global Stories for Grassroots Activists

Please use these powerful stories to inspire yourself and our leaders. Read them to reinvigorate your own group, to help new partners understand our dedication to change, to open their eyes and hearts of your community members, and to create champions out of your representatives, senators, and editorial writers. No one ever became a real champion because they were overcome by data and statistics, but only when that information was combined with stories and life examples that emotionally moved them to take action.

Before each story is a brief background and an example of what you may say as you incorporate the story into your meeting. There is also an example of what you might say after you finish reading it. It’s most effective to customize this section from your own experiences or the experiences of the person to whom you are reading the story.

The Heart of the Problem and the Solution: The Global Fund to Fight AIDS, TB and Malaria

Sharing your stories (or the stories of your friends) with decision-makers can be truly powerful because it emotionally connects them to our issues. When a story about the problem is matched with an example of a solution, stories can move mountains. Here is a copy of a letter sent by one of our volunteers to her senator to illustrate the life-saving importance of the Global Fund to Fight AIDS, TB and Malaria:

Dear Senator Cantwell,

I am in Ghana visiting some pediatricians before I go to do some volunteer work in Liberia for two months. Today I attended a clinic for children who have HIV/AIDS or whose mothers have HIV/AIDS. The rate of HIV in pregnant women here is only about two to three percent, so lower than in other areas of Africa. But seeing the outcomes for these families was a great testament to the efficacy of prenatal treatment of the mother and immediate post-delivery treatment of the infant with retroviral medications to prevent maternal-to-infant transmission of HIV. All of the young infants less than one year of age had been treated to prevent transmission (and also bottle fed rather than breast fed, which is recommended when the family has access to safe formula preparation, as is the case here in the capital city). They were thriving, beautiful children that looked likely to be infection free.

The older children, who had not received treatment during the prenatal period and immediately after birth, were struggling with growth delays and infections such as TB, fungal skin infections, malaria, and pneumonia. Two of them were lovingly cared for by tired looking grandmothers because their mothers had died from HIV/AIDS. Their clinic and hospital care is free and the price of medications is markedly reduced through funding from the Global Fund for HIV/AIDS, TB and Malaria. For example, one father said that he purchased the AIDS medications for his 11-year-old son (who was a lively boy that loved to play soccer, but only the size of an eight-year-old in the US and had just recovered from active TB) for only about $8 every 3 months. Families that are very poor and can’t pay can still obtain the medications thanks to the Global Fund.

The sad part of the story is that there is an estimated $4–6 billion gap in funding for the Global Fund this year that is needed to continue and expand these very effective treatment programs for children here in Africa. So far, the developed countries that have been donors, such as the US, haven’t stepped up and allocated more money to continue and expand these programs. Please push for expanded funding of the Global Fund. It is money well spent by the global community to raise healthy children and have mothers be able to live with good health to care for their children. Without it, we will have worsening poverty for these very resource strapped countries which will breed more war and terrorism.

— Seattle RESULTS volunteer Elinor A. Graham, M.D., M.P.H.

The Heart of the Problem: Tied Food Aid

As RESULTS volunteers, we are not here to ask talk to you on behalf of the poorest. We are here to talk to you about issues of poverty that no one wants to discuss. We are here to ask for change that many people don’t want. Change that is vital to helping the poorest. We’d like to read this brief excerpt from an article about the impact of U.S. tied food aid policies. It will only take a moment. The article is titled, “Dead Children Linked to Aid Policy in Africa Favoring Americans.” Here is how the article starts.

The bag of green peas, stamped “USAID From the American People,” took more than six months to reach Haylar Ayako.

For seven of his grandchildren, that was a lifetime.

They died as the peas journeyed from North Dakota to southern Ethiopia. During that time, the American growers, processors and transporters that profit from aid shipments were fighting off a proposal before Congress to speed deliveries by buying more from foreign producers near trouble spots. As a result of legal mandates to buy U.S. goods, the world’s most generous food relief program wasn’t fast or flexible enough to feed the starving in Ethiopia’s drought-ridden South Omo region this year.

“I am so grieved that I lost those children,” said Ayako, a Bena tribesman, speaking in his local Omotic language. “They died of the food shortage.”

The dry peas Ayako took home almost eight weeks ago had traveled more than 12,000 miles (19,300 kilometers) by rail, ship and truck, starting 15 miles south of the Canadian border with their harvest in August 2007. Stops included Lake Charles, Louisiana; Djibouti, the small African country whose capital on the Gulf of Aden serves as a port for food aid; and Nazareth, Ethiopia, two hours south of Addis Ababa, the capital. Warehouse stays punctuated each leg until the peas finally arrived in the village of Shala-Luka.

U.S. farm and shipping lobbyists have stifled efforts to simplify aid deliveries, leaving Africans to starve when they might have been saved, said Andrew Natsios, a professor at Georgetown University in Washington who led USAID, the Agency for International Development, from 2001 to 2006.

“No one can take the high moral ground against it, so they hide behind closed doors and kill it,” he said. “It’s all done behind the scenes.”[1]

Behind the scenes, children are dying because of our inefficient and ineffective aid policies. President Bush wanted to remove some of these food aid restrictions, and President Obama has also pledge to reduce tied food aid. We ask your partnership in building support in Congress so that our U.S. tax dollars that are spent on food aid actually reach those most in need.

The Heart of the Problem: Children of Poverty

As RESULTS volunteers, we are not here to ask for something for our own families, but for our human family. We ask that you give us a moment to show why we do this work and why our request of you is so important. We’d like to read this brief excerpt from a New York Times article on child labor in Africa. It will only take a moment. The article is titled: Africa’s World of Forced Labor, in a 6-year-Old’s Eyes. Here is how the article starts.

Just before 5 a.m., with the sky still dark over Lake Volta, Mark Kwadwo was rousted from his spot on the damp dirt floor. It was time for work. Shivering in the predawn chill, he helped paddle a canoe a mile out from shore. For five more hours, as his coworkers yanked up a fishing net, inch by inch, Mark bailed water to keep the canoe from swamping.

He last ate the day before. His broken wooden paddle was so heavy he could barely lift it. But he raptly followed each command from Kwadwo Takyi, the powerfully built 31-year-old in the back of the canoe who freely deals out beatings.

“I don’t like it here,” he whispered, out of Mr. Takyi’s earshot.

Mark Kwadwo is 6 years old. About 30 pounds, dressed in a pair of blue and red underpants and a Little Mermaid T-shirt, he looks more like an oversized toddler than a boat hand. He is too little to understand why he has wound up in this fishing village, a two-day trek from his home.

But the three older boys who work with him know why. Like Mark, they are indentured servants, leased by their parents to Mr. Takyi for as little as $20 a year.[2]

We are clear that microfinance targeted to the very poor and that is well run can allow parents to take care of themselves and their children. Our founder asked Muhammad Yunus 19 years ago “what’s the first thing a woman does with the proceeds from her loan?” He expected Professor Yunus to say, “she puts her children in school, or feeds her family better.” What the Nobel Peace Prize winner said was, “Usually, the first thing she does is bring her children home. She couldn’t afford to feed them so she had sent them off, as young as 5 or 6 years old, to work for other families in exchange for barely a handful of rice.” But with microfinance, she can bring them home.

We have decided to use our power as citizens to make a difference, and so we are here to ask you to support microfinance programs that help the very poor.

The Heart of the Solution: Microfinance, Breaking the Cycle of Poverty

Microfinance is not the only solution to the primary school enrollment crisis in the developing world. It is, however, a pivotal tool for helping families educate their children, a tool that can lead to breaking the bonds of intergenerational illiteracy and poverty.

Ten years ago, a visitor from North America sat with a microfinance client in South Asia talking with her through a translator. The translator said, “She wants me to tell you that her son is starting college next year.”

“My son is starting college next year too,” the visitor replied.

The conversation continued and a few minutes later the translator interrupted again and said, “She wants me to tell you her son is starting college next year.”

“I know,” the visitor replied, “my son is starting college next year too.”

They talked a little bit more and then the translator interrupted a third time, “She wants me to tell you her son is starting college next year.”

The visitor, finally getting the picture, asked, “Can you or your husband read or write?”

“No, we can’t read or write,” the client replied.

“Could your mother or father read or write?” the visitor asked.

“No, my mother and father couldn’t read or write,” the client replied.

“Could your husband’s mother or father read or write,” the visitor continued.

“No, his mother and father could not read or write,” the client replied.

“Oh!” the visitor said, finally getting the profundity of the information, “Your son is starting college next year. I finally understand. You must be very, very proud.”[3]

We can not even imagine the type of pride and sense of accomplishing the impossible this mother must feel. We call America the land of possibilities, but we are clear that anyone anywhere can achieve the impossible if they are given the chance and the tools they need to reach their potential. Microfinance is one of those proven, effective tools, and we ask your support for microfinance for the very poor.

The Heart of the Solution: Microfinance, Changing Lives in the Slums of Nairobi

Jamii Bora is a microfinance institution in the slums of Nairobi. It focuses on the very poor, people that everyone else writes off as unreachable. The loans are very small (less than $90). But these small loans — and the support and hope provided by Jamii Bora — have an amazing impact on the lives of the poorest. I would like to share with you a story of a (man/woman) whose life was changed by Jamii Bora (Note: choose the story that you think speaks to you and your audience):

Wilson Maina is a handsome young man with an infectious smile, admired by many in his home Mathare Valley, one of the largest slums in the world. Only a few years ago Wilson was a thug, a violent criminal feared by all. He chose that destructive type of life because he thought it would be better to shot dead by a policeman than to slowly starve to death from poverty. But in 2000 things changed when he heard about Jamii Bora and realized, to his astonishment, that he was welcome to be a member. For the first time in his life he found that people did not look down on him, but instead welcomed him to join the membership. Jamii Bora encouraged him to believe in himself and showed him that he can get out of poverty if he wants to if he is determined enough.

Wilson was moved and stunned that good people could trust him and believe in him — a thug and a criminal. He joined Jamii Bora in early 2000 and today he is a truly changed person. He is a good husband and father and he is running four small businesses. He is now even managed to become a landlord with two rental properties. He started with a loan of 2,000 Kenyan Shillings (US$29) and by the end of 2006 he had borrowed 18 times. He has taken out a housing loan, but now dreams of moving to the new town in Kaputei. Having managed to change his own life, Wilson is now active in counseling other young men to get out of crime. Today Wilson is a model for many and he demonstrates that in Jamii Bora it does not matter where you come from, what matters is where you are going.

Clarice Adhiambo was a beggar in the streets for 15 years before joining Jamiii Bora. She was one of the original 50 members. She started her first steps out of the streets with a loan of only 1500 Kenyan Shillings (US$22) With this she started a business in the Koma Rock neighborhood frying fish and chips to sell to workers who needed an inexpensive lunch. She would fry two or three fish and sell them in small pieces to her hungry customers. Her daily income was no more than what she could get as a beggar, but she was working for herself and proud of it. By using her loan she had gained her dignity and self-confidence. Clarice’s business grew step by step and she was soon able to take bigger and bigger loans.

Today Clarice has a wholesale business selling fish in Gikomba market to many shops, hotels and restaurants and to the small vendors in town. Clarice also has a restaurant serving fish dishes. She has also become a landlord, renting out market stalls to small shops in the Soweto slum. She has brought herself from being a beggar on the streets to being what she considers a rich woman. What’s more, she has inspired hundreds of desperate people to join Jamii Bora and get out of poverty.

Beatrice Ngendo is a single grandmother. She lives with her 12 grandchildren in Mathare Valley. Her children and their spouses have all died of AIDS. Now the grandchildren only have their grandmother to take care of them. Beatrice did not sit down feeling sorry for her self. She said to herself: “I now have to work twice as hard as other mothers in Mathare Valley to feed and educate 12 children.”

Beatrice heard about Jamii Bora and joined as a member in 2000. She now has three successful businesses in Mathare Valley: a grocery store, butchery, a restaurant and a stone house, which allows her to rent out rooms. Her grandchildren are in school and the oldest has just graduated as a qualified nurse and has joined the staff in Jamii Bora’s out patient clinic in Mathare. Beatrice has been a model for many. Anyone that has met her will never talk about problems again but what they can do to follow Beatrice’s example.

Kitana Gona Kizuka lives in the tranquil village of Utange in Kisauni near Mombasa. Like many of the Giriama tribe that live, he is a farmer and keeps cows. He joined Jamii Bora in 2002 at a time when he desperately needed to increase his income. Since his brother had died, his family responsibilities had doubled and his income was not enough to feed his large family.

His first loan was 10,000 Shillings and the last loan was 50,000 Shillings. He has now borrowed five times. He has been able to acquire 4 high-grade cows that give him a lot of milk and good income. Before he joined Jamii Bora he had only had traditional cows that give very little milk. By crossing the new cows with the traditional breed he has now raised 25 high production dairy cows. With his second loan he purchased a water spout from which he now sells water to his neighbors.

Now, all his children, nieces and nephews are in school or vocational training. Katana was the first member to get a Daraja loan from the Mombasa branch. In the future he would like to take a loan out to buy a cow shed for his herd. He is so excited over his new fortune that he has introduced more than 50 new members to Jamii Bora Trust. He says that Jamii Bora has allowed him to “see the light” at the end of the tunnel.[4]

Do you see how powerful microfinance for the poor is? It restores their dignity and their sense of self-worth. It improves their lives and the lives of their communities. We have decided to use our power as citizens to make a difference, and so we are here to ask you to support microfinance programs that help the very poor.

The Heart of the Problem: Child Survival

Like some members of Congress, some RESULTS volunteers have personally witnessed the tragedy of poverty and it has shaped their lives. Many of us are motivated to do our work because of the impact of these stories. We would like to take a moment to share with you how one of our members was affected by what he experienced in Niger. It will only take a moment.

My years as a Peace Corps Volunteer in Niger taught me many things — some of them profound, and some of them tragic. One of the tragic lessons I learned was that the number of parents who experience the pain of needlessly losing a child is not equally shared around the globe. This lesson became particularly poignant the day that Issa, my blacksmith friend and neighbor, walked into my mud hut with panic and shock written on his face. “Please come and see my baby — she’s sick and doesn’t even know who I am,” he managed to get out. When I arrived, the beautiful baby was listless, but breathing. As I watched her and stroked her black hair I could see the life ebbing out of her, her breathing slowing until it stopped. I immediately crouched on the floor, put two fingers on her sternum and tried frantically to breath life back in to her, as Biba and Issa looked on in horror. I knew there wasn’t a doctor or a health facility for miles that could help me, so I just continued working on her. The infant finally expired in my arms and Biba wailed. I never found out why she died. But I knew that she never really had the same chance to live a full life as those who have access to vaccinations, clean water, and medical facilities. I’m pretty certain she was one of the 10 million preventable child deaths that year and I will never forget that day.[5]

The sadness of this child’s death and how it has moved our fellow volunteer has left an indelible impression on us, and I’m sure you, too. Thanks to U.S. leadership, there are fewer stories like this one today, but 26,000 a day is still too many. It is critical that the U.S. invest in proven, effective child survival programs to help children. How can we work with you to accomplish our mutual goals of savings children’s lives?

The Heart of the Solution: Child Survival

As RESULTS volunteers, we are here to speak not for ourselves, but on behalf of those who do not have a voice. The most vulnerable and voiceless are children. As you know, 26,000 children die every day, mostly from preventable causes. But we know how to save them. I would like to read a brief excerpt from a story about the fate of children in Ethiopia. It will only take a moment.

Mubarek weighed barely eight pounds when he arrived at the Kuno Alimena Health Post in Ethiopia’s drought-affected Gurage Zone. His weight would be average for a newborn baby, but as a toddler, he weighs approximately one-third of what he should. His diagnosis is severe acute malnutrition.

Still, Mubarek was lucky; his mother brought him to the weekly UNICEF-supported therapeutic feeding program that has been set up to save the lives of severely malnourished children. He did not have medical complications that would require clinical treatment and was able to begin home-based care, receiving weekly rations of ready-to-use therapeutic foods.

But Mubarek’s twin brother was not so fortunate. He died even before his mother could get help.

While therapeutic feeding saved Mubarek’s life, if there is not enough nutrient-rich food when he returns home, he will likely become malnourished again. UNCIEF warns that children with severe acute malnutrition have a 25 to 50 percent chance of dying if they don’t receive help. While this is a story about the acute food shortage in Ethiopia, children are suffering and dying of malnutrition all around the world. It is critical that the U.S. invest in proven, effective child survival programs to help children like Mubarek.[6]

The Heart of the Problem: Maternal and Infant Mortality

As RESULTS volunteers, we try to ensure that suffering is not ignored because it is not seen. Sadly, many of the invisible are mothers and their children. 26,000 children die every day, mostly from preventable causes. And rather than a time of joy, child birth is too often a death sentence for women. We’d like to take a moment to read a story that ran in the Washington Post about a mother-to-be in Sierra Leone that we think encompasses all the challenges the poor face in trying to access health care.

Saio Marah, nine months pregnant and two days into labor, lay on a hospital bed and groaned loudly with each contraction. She had arrived at the rural hospital earlier on the back of a motorcycle, about the only public transport available in this muddy little town in the distant back-country bush of one of Africa’s poorest nations. Now, in a dark and hot labor ward with rain blowing in the open windows and puddling on the floor, Marah grimaced as James Konteh slapped on rubber gloves and examined her.

Konteh, an ophthalmologist by training, is one of only two doctors who serve 300,000 people in this remote district, so he has become a de-facto obstetrician. He placed a plastic Pinard stethoscope — a cheaper, funnel-shaped alternative to a standard stethoscope — to Marah’s massive belly and listened.

“The fetal heart rate is very rapid,” he said. “The labor is obstructed. The baby is in distress so we must operate right away.” Konteh pulled out his cellphone and began dialing his four surgical nurses. It was 6:30 pm, and they had all gone home when their 10-hour shifts ended a half-hour earlier.

Marah had waited too long to come to the hospital, and now the baby, her first, was in trouble. The surgery was urgent, but it would take time to get the operating room team back.

“What can I do?” Konteh said. “There’s nobody here.”

The story now describes the challenges health care workers and mothers like Marah face, which include no electricity or running water and impassable roads. Samuel Kargbo, the British-trained director of the hospital and the only other physician in the country’s largest and poorest district, also explains that:

“. . . many women delay seeking medical care for their pregnancies because many don’t fully understand the risks and are daunted by the costs and distances they need to travel for care. So they tend to rely on poorly trained local midwives. When problems develop, they end up walking, or being carried in makeshift hammocks, for hours or even days to reach the hospital. He says that every pregnancy is a “chance of dying.”“ The doctor couldn’t help Marah right away because his staff had been working since early morning, he noted, and had needed to go home to eat and rest. They came back as quickly as they could.

Marah’s husband Barrie had to run out to a pharmacy and buy a catheter and urine bag for $3. Patients must pay for all supplies, in addition to hospital fees, which is about $10 for a regular deliver, and $70 or more for a C-section. Some operations are delayed while husbands run out to buy rubber gloves for the surgeon.

We learn in the story that Barrie earns $100 a month making jewelry in a local market, and he is very worried how he will pay the full bill. But can imagine how someone earning less than $1 a day would cope? Or if they would even bother going to the hospital? I would like to finish reading a bit of the story so you can find out what happened:

The doctor pressed the plastic funnel against Marah’s belly again, listening for the baby’s heartbeat — an hour and 45 minutes after he first checked. . . . He shook his head. . . . Marah’s baby was dead. . . . There was no oxygen, heart monitor, or blood available. The air-conditioner remained off, despite the heat and humidity. The performed an emergency c-section, just in case there was still a chance at life.

The nurse hurried the silent baby over to a small examining table and pressed its chest with her forefinger. “Nothing,” she said. “No sign of life.” She turned the baby over. “This is a fresh stillbirth,” she said. “This baby has just died.” She put the body on a scale: 6.5 pounds. A good size, otherwise apparently healthy and well developed. “If she had come to the hospital earlier, this baby could have survived.” . . . In this part of the world, the bodies of stillborn babies are often disposed of by the hospital. Stillbirth is such a common occurrence that the hospital has a small, unmarked graveyard set aside for them. Sierra Leone has the highest rate of infant mortality in the world, with 16 percent of babies dying before their first birthday. [7]

A woman’s lifetime risk of maternal death is one in 75 in the developing regions, compared to one in 7300 in developed regions. In Sierra Leone, the rate is one in eight. Every minute, at least one woman dies from complications related to pregnancy or childbirth — that’s 529,000 women every year. And for every woman who dies in childbirth, around 20 more suffer injury, infection or disease — approximately 10 million women — 10 million mothers — each year.[8] We would like to work with you to help these women and their children.

The Heart of the Problem and the Solution: Child Survival

Like many women in rural northern Mozambique, Atea Mussa started giving her children water to drink in addition to breast milk on the day they were born. Her own mother taught her that without water, the babies’ throats would dry out and they might die.

But finding clean water near Atea’s village of Ampivine in Nampula Province is a daily struggle. The area lacks piped water and sanitation is poor because most households have no toilet or latrines. The available water often carries microbes that cause diarrhea, putting children at risk of malnutrition even when food supplies are adequate.

When Atea was pregnant with her third child, new ideas about child rearing came to the village and surrounding areas. The radio began to play messages about the benefits of exclusive breastfeeding and ways to improve children’s diets with local foods. A community volunteer trained through a USAID program offered free nutrition and hygiene classes, which Atea attended. Although others initially were skeptical, Atea trusted Amina Abubakar, the new community volunteer or “animadora” in Portuguese. . . .

When Atea gave birth to her son Nelson Aldi in late 2003, she broke with tradition and followed the animadora’s advice, giving the baby nothing but breast milk for the first four months. Then she added porridge mixed with nutrient-rich foods like peanuts and sesame to his diet. Nelson not only survived without water, he thrived. At six months, he is a happy, chubby baby known and even envied in the community for the fact that he is rarely ill and has never suffered from diarrhea.

When a visitor asks the animadora how she knows her program is working, she takes Nelson from his mother and lifts him into the air with a big smile. Because of his example, more mothers are adopting new ways of feeding their children. “The children are healthier and the sicknesses are less severe,” Amina observes. “The mothers always congratulate me and are grateful.”

Beliefs are changing even among the older generation. “The grandmothers see the advantages because the children are growing well and don’t suffer,” says Atea, who is proud that her son has a healthy start in life. She hopes Nelson will grow up “to help others in the community” as a nurse, a highly respected profession. If Nelson could talk, he would say “thank you” because he is growing well and when you grow well, school is easy.[9] Sadly, UNICEF reports that the majority of the children in this region have stunted growth. But thanks to U.S. leadership, there are fewer children today suffering from malnutrition, but even one is too many when the world has the resources for smart, proven interventions to save these lives. It is critical that the U.S. invest in proven, effective child survival programs to help mothers like Atea.[10]

The Heart of the Problem and Solution: Tuberculosis and HIV/AIDS Co-infection

We would like to take a moment to talk to you about someone RESULTS is very close to. Winstone was born in Zambia as the sixth of thirteen children. He was diagnosed with polio at the age of three, has been living with HIV/AIDS since 1990, and became sick with — and was cured of — TB in 1997. But TB has affected his life much more than his own story. We’d like to read a short description from Winstone about the impact these two diseases have had on his life. His story has moved us out of our ignorance and complacency and like him, we are now dedicated to fighting this deadly co-epidemic. This will only take a moment.

My brothers Erasmus and Christopher got tuberculosis at around the same time. It was so tragic, Erasmus died on the 7th of December 1990 and his wife died the following day, and then Christopher died a week later. And then there was Shadrek, he was the eldest of all of us, he worked for BP, he was a truck driver. He left 6 children. He died in 1996 from tuberculosis as well. His wife died the following year. Danny, he was the youngest. Danny was a really good musician, he used to work in South Africa. Then he came back and we started living close to each other, we became very close. He died in 2003.

They shouldn’t have died. TB is preventable, whether people are HIV positive or not. TB treatment gives patients more time. If my brothers had survived TB they might have lived long enough to access HIV drugs like me.

We adopted my son Michael before the era of prevention of HIV from mum to child. He is 9 years now and has had TB but got cured. He is on antiretrovirals for HIV infection. I also directly support Matildah and Clara who are my late brother Shadreck’s daughters, Musa and Morey who are late Christopher’s kids. There are other nieces and nephews that I help too but they are looked after full time by my sisters.

Winstone’s story highlights that we cannot separate the epidemics of TB and HIV/AIDS and that unless we act more urgently and with the resources commensurate with the problem, TB will continue to be a needless tragedy that aggressively kills those with HIV/AIDS. While there is no cure for AIDS, there is a cure for tuberculosis. This World AIDS Day, we cannot forget that the fight against AIDS cannot be won without the fight against TB. We hope we can work with you to increase the U.S.’s support for bilateral TB programs and the Global Fund to Fight HIV/AIDs, TB and Malarai, which is having a huge impact in Zambia and many other countries.

The Heart of the Problem and the Solution: Tuberculosis

We would like to read you an excerpt from a Partners in Health doctor’s account of the challenges, but also the transformational power, of detecting and treating TB and HIV/AIDS in poor countries. He traveled to a village in the mountains of Lesotho, which took six hours by horse, to visit a very ill patient named Mathabo.

When I entered her house, Mathabo was too ill to sit up on her bed to greet me, though I knew she wanted to. She was coughing a lot and was extremely thin. Her skin-tone was not a healthy colour, most likely from anemia. Because she wasn’t able to move, I couldn’t weigh her, but I estimated her weight to be only around 35 kg (less than 80 pounds).

At that time, Mathabo was 35 years old. She had lost her partner over seven years ago, most likely to AIDS. She had pulmonary TB three years ago and had been treated for pneumonia several times. Her symptoms included severe weight loss, coughing, night sweats, diarrhea, thrush, loss of appetite and loss of skin tone. Mathabo gave her consent and I tested her for HIV. Her test showed positive. I also diagnosed her to have . . . TB, so I started her immediately on TB medication and fluconazole. I drew her blood to send for a CD4 count and gave her some money for food.

Unfortunately, we never received the results of Mathobo’s CD4 test. As I soon learned, many samples never make it to the lab. They simply disappear somewhere along the line of drawing samples, coordinating them, shipping them down with the pilots (since the clinic is accessible only by small planes), and then couriering them to the central lab in Maseru. Even when samples do get to the lab, the results often fail to make the reverse trip back to us in the mountains.

Two weeks after seeing Mathabo, I was visited by her VHW (Volunteer Health Worker) at the clinic. She reported to me that Mathabo was doing much better already. . . . When she first stepped into the room, I didn’t recognize her. I had to rely on the VHW to vouch that this was Mathabo. Her complexion was much improved and she had gained some weight. Although we still didn’t have a CD4 result for her, I decided that she was ready to begin antiretroviral therapy. She no longer had any of the symptoms she had over a month ago and she weighed 46 kg (102 lbs). I took another blood sample to send to Maseru for a CD4 count and enrolled her into our food program, where each patient gets enough food every month to feed him or herself plus four family members.[11]

Mathabo almost died of TB, despite drugs costing as little as $20 that are effective in 95 percent of cases. The challenge of testing for and fully treating TB, described in this account, is leading to the spread of drug-resistant TB, which is entirely man-made and arises from incomplete or ineffective treatment of standard TB. Anti-retrovirals do not provide protection from TB, and the spread of drug-resistant TB threatens to rollback progress fighting HIV/AIDS in Africa. This is why we advocate for increased bilateral funding to fight TB, and increasing the U.S. commitment to the Global Fund to Fight AIDS, TB and Malaria, which since 2001 has detected 5 million cases of infectious TB, cured 3 million people, and treated 24,000 cases of drug-resistant TB.

The Heart of the Problem and the Solution: HIV/AIDS and Orphans

We would like to share with you a story that we feel highlights why we are here with you to talk about global health, and why we are asking you to support smart foreign assistance that helps save lives and rebuild lives. It is a about children in Mozambique. It will only take a moment:

It is mid-morning but Rosina, 16, is still at home, hurrying to finish her domestic chores before going to school. Her home is a small, dark hut where she has been living for about a year with her three brothers, the youngest of whom is only three years old.

Their mother died about two years ago, and they don’t know where their father is.

“I look after my brothers like a mother,” says Rosina. “Our life here is very difficult. Every day I have to go and fetch water in a place a long way from here, go into the bush looking for firewood, cook for my brothers and also go to school.”

Rosina and her brothers are among an estimated 510,000 Mozambique children who have been orphaned by AIDS.

Despite her difficulties, Rosina is receiving help to maintain the house and continue her studies. “We depend on the little money and food we receive for the work we do on our neighbors’ fields, and on the support we receive from Vukoxa,” she says.

Vukoxa is a community-based organization whose Living Together program helps child- and elderly-headed households caring for orphaned and vulnerable children in Mozambique. With support from UNICEF and its partners, the program provides assistance with income, land, small loans for agricultural production, access to water and sanitation, and other basic needs.

“We set up a committee with members of the community here in Chiaquelane because we noted that there are many orphans living on their own, and many elderly people looking after children, who needed our support,” explains the Chairperson of the Vukoxa Committee in the community of Chiaquelane, Anita Ussivana.[12]

For us, this story highlights the critical importance of expanding U.S. support for the PEPFAR program, fighting TB, and the Global Fund, which are helping to prevent the tragedy of HIV/AIDS orphans and to provide life-saving interventions for these vulnerable children so that they can grow up to be healthy and productive adults.

The Heart of the Problem and the Solution: Education for All

We would like to take a moment to read a short excerpt about a young man in Rwanda who had been denied an education, but is now attending school because educational barriers have been lifted.

Jean Pierre Nzamurambaho dropped out of school in the middle of his third year of primary school when he was just 12 years old. “I decided to drop out because I was tired of being sent home because we couldn’t pay school fees,” explains Jean Pierre in his native language of Kinyarwanda. “I spent two years doing domestic jobs, but I could not see any future for myself.”

In 2004, two years later, the Government abolished primary school fees and replaced them with capitation grants (grants that are determined by the number of pupils attending the school). Jean Pierre was able to return to his primary school in a rural village of Rulindo district in the Northern Province. His ambition now is to become a teacher and provide an education for the children of his village.

Jean Pierre is typical of many of the pupils who have been given a chance to study. Between 2002 and 2006, the net enrolment rate rose from 73.3% to 94%, which means over 500,000 more children getting an education. And this includes girls, whose education has long been sidelined in Rwanda in favor of male children.

13 year old Seraphine had the same experience. She says, “During my first year, I was always sent back home because of either school fees or uniform. Nowadays, teachers are no longer sending us back home, and even if I don’t put on uniform, I come and study freely. I only have to make sure I’m clean.” This new opportunity has allowed Seraphine to set her sights on becoming a nurse in the local health clinic.[13]

When we learned that children are denied an education because they are poor, we could not sit by and not take action. We hope you feel the same way, and want to discuss ways we can work together to provide to ensure that the U.S. effectively contributes to improving access for all children to a quality education.

The Heart of the Problem and the Solution: Education for All

We are here to talk to you about helping all children receive a free, quality education. We would like to take a moment to read a story about a child in Guinea-Bissau that motivates us, and we hope you, to be a leader for change.

Like many girls in Guinea-Bissau, Mariama Sambu, 10, has a busy life. She rises at six each morning to help with household chores, which is no easy task when you share your small home with 18 other people.

The structure of her house – bricks made of mud, a dirt floor and a corrugated metal roof – stands as a reminder that Mariama lives in one of the five poorest countries in the world. There is no electricity or running water, so Mariama must walk each morning to a nearby well, which was provided by UNICEF. Before this well was built, she had to walk 2 km for water, which left her little time to prepare for class.

Now she arrives at class fully prepared and eager to spend her morning learning. Mariama has quickly emerged as one of the top students in the village. She hopes her journey will continue after she finishes her schooling.

“I want to be a teacher, to help my mother and father,” says Mariama. “That would give us an easier life.” [14]

We’re sure you’re as moved as we are by the power of education to transform lives of children and their communities as. We’d like to work with you to ensure the U.S. effectively contributes to improving access for all children to a quality education.

The Heart of the Solution: Education, Changing Lives and Minds

We are here to talk to you about something I am sure we all care deeply about: education for all, especially for children who have been denied this right for too long. Many RESULTS volunteers are also active in other organizations and overseas. We’d like to take a moment to relate a story from one our volunteers about her experience working to provide education for girls in Afghanistan.

It took place back in 2002. There is a little Afghan girl who was about 9. I don’t know her name, but I’ll call her Parvana. After the Taliban was removed from power, girls were allowed to go to school for the first time, but Parvana’s father did not allow it. While all of her friends started the first grade, she was told to stay home. Day after day, she saw her classmates walking into school. Seeing the excitement of her friends, she started sneaking into school. One of the teachers approached her realizing the danger. Although this little girl could have been publicly whipped or stoned for disobeying her father, she willingly took the risk. Even at this young age, she realized the importance of education.

Well, one day, Parvana didn’t show up at school and her colleagues feared the worse. Well, the story is this. Earlier that week Parvana’s father had received a letter from a relative in Pakistan. He was illiterate; he couldn’t read it. Nor could anyone else in his family. Subsequently, we later learned how this little girl bravely came forward and told her father that she could read it for him. Instead of beating her, he actually embraced her. Although he was shocked, he was proud. She was the first person to read in his entire family. This story reverberated throughout the district. That girls’ school went from 420 girls and 8 teachers to almost 1000 girls and over 20-some teachers. Other girls’ schools in the area started and blossomed as well.

This story reminds us about the power of education to build confidence, respect, self-worth, and the respect of your community. This transformational effect has the power of “positive deviance” — changing norms and lives by leading by example. Yet there are still at least 72 million primary school aged children not in primary or secondary school, the majority of who are girls like Parvana. How can we work together to increase U.S. support to help these children achieve a quality basic education?

The Heart of the Solution: Education, Providing Hope for the Future

I’d like to share a story with you about the moment that Gene Sperling, former chief economic advisor to President Bill Clinton, truly understood why we must support providing every child with a quality basic education.

In 2000, Mr. Sperling was in a village an hour and a half drive from Dakar, Senegal. Mr. Sperling was in Dakar to lead the Clinton administration’s delegation to the United Nations Education for All Conference, a meeting dedicated to ensuring that all primary school-aged children in the world would be enrolled in school. The goal was to have been achieved by 2000, but by that year, there were still more than 100 million children not in primary school. After the conference, Mr. Sperling visited a village that only had a first and a second grade:

We went to listen to the second graders. They were coming up to the board doing . . . math assignments. There were about 80 kids in the class, one teacher. And at the end I said to the guy from the U.S. Embassy, “Can we take some questions?” And he said he didn’t want me to have them take any questions. And I said, “Why?”

He said, “because they’re extremely poor children and you’re a very rich man to them and if you tell them to ask questions, one of them might make an inappropriate request.” So the guy from the Embassy was worried that if I took questions from the second graders they were going to ask for money or shoes or something. So I waved that off and said, “Don’t worry about that.” So sure enough we asked for questions and the first child puts his hand up, and it was a young boy, and he says “Do you think next year at our school we can have a third grade and a bathroom?”

I’ll tell you, if there was a moment I became committed to [this] issue, it was just that simple. Here we were looking at a school for just first and second graders and the reality [is], here’s a kid who’s finishing second grade and all he wants to do is go to third grade and it’s just not in the cards . . . and then a bathroom. It never crossed my mind there wasn’t a bathroom at [this] school. And all I could think in light of this guy from the Embassy’s line was, that was hardly an inappropriate request, for a child to want to go to third grade, or fourth grade, or fifth grade and the idea that essentially the answer was no. Nobody cares enough to make sure this school has a third, fourth, fifth, sixth, seventh, [or] eighth grade. It’s just so heartbreaking and so wrong.[15]

A simple bathroom and another year of school . . . that’s all this child wanted. How can we work together to make sure children who want to go to school can?

[1] Alan Bjerga, “Dead Children Linked to Aid Policy in Africa Favoring Americans”, Bloomberg, 9 December 2008. http://www.bloomberg.com/apps/news?pid=20601116&sid=aU7BLQWMss2k&refer=africa#.

[2] Sharon LaFraniere, “Africa’s World of Forced Labor, in a 6-year-Old’s Eyes,” The New York Times, 29 October 2006, http://www.nytimes.com/2006/10/29/world/africa/29ghana.html

[3] The Microcredit Summit Campaign, 2007 State of the Campaign Report.

[4] “Members’ Voices,” Jamii Bora, http://www.jamiibora.org/membersvoices.htm

[5] Story courtesy of Ken Patterson, RESULTS grassroots member and current Global Grassroots Manager.

[6] UNICEF, 26 June 2008, http://www.unicefusa.org/news/news-from-the-field/unicef-deputy-executive.html.

[7] Kevin Sullivan, “In Sierra Leone, Every Pregnancy Is a ‘Chance of Dying,’” Washington Post Foreign Service, 12 October 2008.

[8] World Health Organization, “Why do so many women still die in pregnancy or childbirth?” http://www.who.int/features/qa/12/en/index.html

[9] UNICEF, “Fighting Childhood Malnutrition in Mozambique,” http://www.usaid.gov/stories/mozambique/ss_mozambique_atea.html

[10] UNICEF, 26 June 2008, http://www.unicefusa.org/news/news-from-the-field/unicef-deputy-executive.html.

[11] Jonas Rigodon, “A doctor’s journal: Home visit in the mountains of Lesotho,” http://www.pih.org/inforesources/news/Jonas_docs_story.html.

[12] Emidio Machiana, UNICEF, “Support for households headed by children and the elderly in Mozambique,” Chokwe District, Mozambique, June 19, 2008, http://www.unicefusa.org/news/news-from-the-field/support-for-households-headed.html.

[13] UK Department For International Development (DFID), “Free education means a future for Rwanda’s children,” 15 October 2007, http://www.dfid.gov.uk/casestudies/files/africa/rwanda-schools.asp

[14] Thomas Nybo, UNICEF, “Rehabilitation and training programmes give girls a better education in Guinea-Bissau,” 3 March 2008, http://www.unicef.org/girlseducation/guineabissau_43069.html.

[15] Story courtesy of the Microcredit Summit Campaign’s 2007 State of the Campaign Report.