The Last Shall Be First: Haitian Women Taking Steps To End Poverty (Forbes)

FORBES | How is it possible that the people of the poorest country in the Western Hemisphere have to shoulder repeatedly the impact of one natural disaster after another?

And what can we do as one of its closest neighbors – and by far the wealthiest country in the hemisphere – to best empower the people of Haiti to respond and to rebuild and indeed eventually to prosper after disaster strikes?

These are the questions we ask today as we see a people struggling to recover from a devastating hurricane earlier this month and an ominous rise in cholera outbreaks.

These are also the questions that a delegation of faith-based influencers from Hope Through Healing Hands and CARE asked last month as we visited Haiti to see what’s working and what’s not in terms of social and economic progress since the destructive 7.0 magnitude earthquake in 2010.

Read more at Forbes.

Helping Haiti Build Back Better

(The Washington Times, July 13, 2012)

As a board member of the Clinton Bush Haiti Fund, I traveled to Haiti last month to check on the post-earthquake progress being made through the fund’s projects. What I saw confirms that developmental aid can have a greater impact than the humanitarian aid most people know.

Moments after the massive earthquake shook Haiti, more than 200,000 people died and nearly $8 billion worth of damage was done. Homes, businesses, schools and hospitals crumbled, all in a country already experiencing 70 percent unemployment. As a surgeon, I joined a volunteer medical response team from Samaritan’s Purse, and in the days following the quake, we helped care for hundreds of injured patients.

To lead the U.S. response, President Obama asked former Presidents Bill Clinton and George W. Bush to raise money to help Haiti build its own sustainable path forward. The fund began making targeted investments, using a variety of tools to help Haiti “build back better.”

The problem with most disaster aid is that it’s temporary. For instance, flooding a developing country with free food and medicine can drive the small farmer or pharmacist out of business, further hurting the economy and leaving residents with less. Aid can be more effective if helpers buy food locally and work through local clinics to support, not undermine, local capacity.

This is why the Clinton Bush Haiti Fund embraced a new model that focuses on promoting economic growth and spurring job creation.

Economic growth generates lasting change, attracts investment, supports entrepreneurs and empowers citizens, providing them with tools to determine their own destiny. After billions of charitable dollars and donor aid are spent, the success — and sustainability — of Haitian reconstruction will depend on one key thing: a vibrant, inclusive private sector.

The fund recognized that economic growth calls for new development tools to facilitate access to capital. A simple grant can encourage dependency on free money — an untenable position in the long term. Alternatively, a program-related investment — a loan or equity investment — is a tool that brings about self-reliance and leads to sustainable growth. These tools come with contractual complexities and nonpayment risks, and the typical nongovernmental organization or development agency thus shies away. But the Clinton Bush Haiti Fund embraces this risk. In doing so, we are teaching a new pattern of development, catalyzing private support over public by a ratio of almost 4-1, and expanding the ability to use these funds. When these investments succeed, we reinvest the money for social and economic good. This is a cycle of smart investing.

In my visit to Haiti, I saw the power of these investment tools. One example is the Artisan Business Network (ABN), which the fund helped create with a combination of grants and loans to the artisan sector. The ABN connects more than 900 Haitian artisans, centralizing and guaranteeing product development, packaging, quality control and distribution to open doors to international markets.

When I visited the ABN hub in Port-au-Prince, I was picking out earrings for my two nieces alongside New York buyers selecting products for a bulk order. Already, the collaboration has seen large orders from retailers, including Macy’s and Anthropologie. Now other organizations are looking at the ABN as a scalable model. By combining grants and loans, we ultimately provided a hand up, not a handout, all while celebrating the culture and dignity of the Haitian people.

In addition, the fund makes equity investments, as we did for the Royal Oasis Hotel, which I visited. Under construction when the earthquake hit, the hotel faced a severe financing gap. The fund stepped in, providing equity that catalyzed contributions from other investors.

To date, Oasis has created more than 600 construction jobs and will sustain 300 permanent jobs. Equally important, its economic and human impact will ripple through the community, helping surrounding businesses, from shops on Oasis’ first floor to restaurants, airlines, tour guides and more. Indeed, it’s estimated that for every job created in the hotel, three indirect jobs will be supported in the surrounding community.

For the Oasis project, the fund did what the presidents wanted — it made a strategic investment, served as a catalyst and paved the way for others. The Oasis is more than a symbol of what it means to build back better — it will send the message that Haiti is truly open for business.

From health care to mobile media, we have started to think differently about how to achieve the best outcomes, improving the quality of life at home and abroad. It’s time we looked equally hard at aid and development, challenging the old ways of doing business, experimenting with new tools and models, and aiming to create self-sustaining economies and entrepreneurs. In that regard, a good place to look for such innovative development is the investments made by the Clinton Bush Haiti Fund.

William H. Frist is a former heart and lung transplant surgeon and served as the U.S. Senate majority leader from 2003 to 2007.

This article was originally featured in The Washington Times


The world needs more health-care workers — millions more

(The Week, Posted on June 19, 2012)

By Bill Frist, M.D.

The most impressive part of any hospital or health clinic is the caring, skilled employees who prevent and treat illness. But the workforce we have is not enough.


As I visit health programs in far off corners of the world and right here at home, the most impressive part of any hospital or clinic is the health workers themselves — the hands behind the health care that is provided to mothers and newborns, to children and the elderly, to teens and adults to prevent and treat illness.

Health workers heal. It’s as simple as that. And in this country, and around the world, there are not enough of them. Doctors are included in that shortage, but it doesn’t stop there. Recent estimates suggest the world is short some 4 million to 5 million community health workers, midwives, pharmacists, lab technicians, nurses, and doctors. Fifty-seven countries have severe health workforce shortages — meaning there are less than 23 clinicians per 10,000 people.

And health workers, particularly in developing countries, are scarcest in the poorest communities and neighborhoods — both rural and urban — where poverty, poor sanitation, and disease conspire to take the lives of children and adults through preventable killers like pneumonia, diarrhea, pregnancy complications, and tuberculosis.

Fifty-seven countries have severe health workforce shortages.

Later this week I am heading back to Haiti with the Clinton Bush Haiti Fund to review past investments in sustainable human health capital. Haiti is in dire need of indigenous health workers who are from and remain committed to their local communities. Long-term health and economic results can only be achieved by partnering with Haitians to build health training and service programs that they own and that they populate.

In targeted areas around the world, training armies of much-needed health workers has become a smart, key goal of U.S. foreign assistance. We are helping train new midwives, community health workers, lab technicians, and nurses through partnering programs supported by the U.S. Agency for International Development, the National Institutes of Health, and the Centers for Disease Control and Prevention. These new health workers are serving in communities hardest hit by infectious diseases and the complications from pregnancy and childbirth.

And it works! Countries that have made a concerted effort to increase the numbers and skills of their health workforces have shown tremendous progress: Malawi has trained more than 10,000 health surveillance assistants in the past 20 years, and in the same period child mortality dropped almost 60 percent. In India, turning normal community members into lay health workers to support healthier newborn care practices reduced newborn deaths by over 50 percent.

Training community-level health workers does not have to be expensive — people who can provide the most basic levels of treatment for sick children and promote healthy practices can be trained for as little as $300. More-skilled community health workers and midwives cost roughly 10 times that amount to train. These workers provide the lifesaving interventions needed to address most of the leading causes of death of newborns and children — all with no need for huge medical school bills. It’s basic health care, but it is lifesaving.

Highlighting the humble service of health workers around the world is the subject of a campaign launched by Save the Children, with whom I have traveled to countries like Bangladesh and Mozambique to witness these health workers going about their daily tasks. The care is effective and affordable. In fact, I think we in the U.S. have a lot to learn from these community health workers delivering local care. Take a look at some of the powerful stories at, where you glimpse the simple and affordable care provided by people who go the extra mile on behalf of others.

No matter what diseases and conditions are threatening, and what new technologies for treatment might come along, we can say for sure that progress will depend on an expanded army of health workers, properly trained and placed, with the right skills and supplies, intent on delivering the best quality health care possible.

As we look at America’s international assistance around the world, surely one of the best examples of success can be seen in the faces of these committed community servants.


This article was originally featured in The Week