From the beginning we’ve been using micro-fundraising and peer-to-peer connections to raise funds. We always focused on supporting grassroots projects led by local, community members who wanted to increase access to basic health for their communities. We focused early on engaging young people and utilizing connections within a network in order to make change and replicate it. Many of the strategies that made our organization exciting, innovative, and successful have spread across the non-profit community. Now there isn’t an organization out there that skips a beat talking about peer-to-peer fundraising, network utilization, campus chapters, or the need for local control of international aid projects.

As times have changed and the needs of our members have evolved, we have been flexible and have grown our organization with those needs. This year marks our 10th anniversary of the start of an Eagle Scout project in 2001, led by a 14 year-old, that raised funds to purchase an ambulance for a health center in rural Uganda. Since the successful completion of that project in 2002, we have supported projects in 5 different countries with health issues ranging from access to medical supplies, nutritional needs, and HIV prevention. Check out our 10 year impact!

As our organization has evolved we have been uniquely able to adapt and implement various methodologies and theories of change. One that has been a cornerstone of our member training is a focus on “Allies in Development.” This training was developed from a range of resources to bring understandings of privilege and international development to our members. Being an ally means that our members recognize that there is a degree of detachment that comes from the privilege of activism on a campus to the health realities on the ground.

We are students and young people, but we can’t save lives. We CAN utilize our knowledge and resources to better support the work of projects and organizations that CAN implement community-based solutions.

That is why SCOUT BANANA is restructuring as a member-owned international development cooperative organization. There is no reason that a non-profit should collect your donations, but you have no participation beyond donating. Likewise, there is no reason that members and donors should be disconnected from the people implementing the funds they donate.

Our goal of engaging young people in meaningful international development efforts to improve access to basic health across Africa can best be accomplished with a strong network of invested individuals working within their campuses as Allies in Development and partnering with grassroots projects in need of resources and support. Become a member today and impact our work!

Learn more and Become a Member at: http://scoutbanana.org/activate

Paul Farmer supports A Million Moms

(Paul Farmer talking about better health services for maternal and child health.)

Over the years, many programs have focused on the need for greater support and focus on women’s rights, maternal health, and the important role of mothers when it comes to healthy children, families, and populations. Not all programs have been implemented equally, some have been more condescending to women than supportive and others just were not enough to have a real impact. The focus on women seems to come and go like a fad – now prominent with The Girl Effect. Hopefully we see the focus on Moms and maternal health stick around with some strong research to support programs with a focus on family and population health.

Over the years this blog has also hosted a debate that we can’t throw other programs out of the window just because women focused programs are the fad. There is still a place for engaging men and arguably one that cannot be ignored. Men may not seem to have as much influence on family health, but men are the ones who often hold the decision-making power for the family or community. Therefore, to disengage men potentially jeopardizes the success of any program success targeting women.

Today was an hour-long tweetchat for #AMillionMoms - the A Million Moms Challenge part of ABC News’ Save a Life Program sponsored by The Gates Foundation

Seven billion people, up from six billion in just 12 years. An absolutely astounding figure. The announcement of the birth of the seven billionth person on Earth was met this week with cautious celebration, however, given the stunning speed at which we arrived at this milestone and governments around the world were faced with a problem we can’t afford to ignore much longer. It’s an undeniable fact that the world cannot accommodate much more than than this for much longer at our present rate of resource consumption and environmental degradation. So the question becomes how do we slow down Mother Earth’s astounding population growth rate?

Well an obvious starting point is to look at areas of the world with the highest population growth rates and find solutions to reduce said rates, which is exactly what New York Times columnist Nicholas Kristof has done in his editorial this morning. Kristof cites high birth rates in countries such as Chad, the DRC, the Republic of the Congo, and Somalia as contributing substantially to the world’s high population growth rate and proposes more funding globally for contraceptives as the beginning of a solution. Although I absolutely agree with him that contraceptives should be freely available to women globally, I am hesitant to be optimistic on this solution’s potential.

For one, funding for this type of initiative would depend heavily on more developed, Western countries, like the United States. While these countries absolutely have the resources to finance such a ground-breaking initiative, it is unlikely to obtain enough support given the global economic problems they currently face, as well as the religious opposition to birth control and family planning in the United States. Secondly, before we begin to reduce population growth rates in less developed countries, especially in Africa, it is of critical importance that we examine why women are having upwards of five and six children in some areas. More often than not the children are needed for family support, especially in areas with economies heavily dependent on agriculture, or where diseases such as HIV/AIDS and Malaria have destroyed families and communities.

Addressing issues of poverty, disease, and education in conjunction with providing free contraception to women in poorer countries is a much more holistic solution to a globally relevant problem. Governments all over the world should take the 7 billion mark as an opportunity to push policies that manage and reduce the very problems that got us here. That way we as a global society learn something from this unprecedented milestone; otherwise, it just means perpetuated inequality, poverty, and environmental degradation for Africa and the world.

The AIDS Healthcare Foundation (AHF) has put together an amazing event to promote HIV testing and treatment among young people in South Africa. In a country where there is still a large stigma towards testing for HIV, especially among young people, this is a powerful example of using youth cultural influences to get the message across. AHF also offered free testing and counseling at the event.

What strategies have you heard of to get young people involved in their own health? Do you think hip hop can change people’s minds about testing for HIV?

This past summer I was fortunate enough to spend three months working at an NGO in Cape Town, South Africa. So of course I was expecting to be bombarded with questions about how my trip to South Africa was upon my return home. Somewhat contrary to my expectations, however, I was repeatedly asked how my trip to Africa was. I thought this was especially peculiar because when my sister returned from her study abroad in Italy last summer, no one asked her how her time in Europe was, people always asked about Italy. Most of the time I would specify that I had traveled specifically to South Africa and tell them about my trip. At first I figured that the people asking had just forgotten where exactly in Africa I was staying but when it happened more and more frequently I began to think that this question wasn’t necessarily indicative of people forgetting where specifically in Africa I lived, but instead of a widespread view of Africa held by many in the West as a uniform, homogenous continent. Basically that the differences between places like Egypt and South Africa, Madagascar and Mali are negligible.

This image of a uniform continent without much variance between countries doesn’t just develop on its own, either. It is informed and perpetuated by a number of different mediums we all encounter on a daily basis: our education system, entertainment industry (movies, TV, music, etc.), NGO’s and the non-profit sector, and, perhaps most importantly, the media. All of these institutions reflect biased notions of Africa, for better or worse, and it is up to us, as consumers of the information and discourses they sustain to separate fact from fiction, whole truth from half-truth, and imagined Africa from actual Africa.

This recognition of our own individual biases informed by our experiences as Westerners is the first step in the very important process of breaking through negative and imagined stereotypes on Africa and discovering the truth about a continent with as much diversity, if not more, as anywhere else.

And by the way, my time in South Africa was absolutely amazing. It is truly a beautiful country in so many ways.

We’ve all heard about how women in many parts of the world are still marginalized and considered second-class citizens; we even continue to struggle with gender equality in the United States. However, before moving to a developing country, I never really understood what it meant to be a woman in such a culture.

Here in Uganda, the men are definitely the decision-makers, the ones with the power. While urban areas are becoming more gender-equal than before, most people still consider women and men to hold very distinctive gender roles, with the household work left to the women but the household decisions and prestige being given to the men. Women are seen as weak, yet they are the ones doing most of the manual labor for the home, such as fetching water (jerry cans are heavy!) and firewood. The women care for the children, but if the couple ever separates, the children generally belong to the father (who never actually cares for them – he either hires someone or already has another wife). Here, there is no such thing as rape within marriage, legally or culturally. Men pay a bride price (often paid in cows or other in-kind payments), which means the man has a huge amount of leverage over his wife.  She belongs to him, and has no right to refuse something like sex.  While becoming less common, “marriage by abduction” does happen, in which a man kidnaps a girl who has refused to marry him and rapes her. The girl’s ‘purity’ is then ruined, and out of shame, she accepts to stay as his wife – she usually feels she has no choice, as many families and communities would disown her at this point, and few other men would want her. If a woman wants to use a condom with her partner or go for HIV testing, she is accused of sleeping around (even though it is commonplace for men to have extramarital affairs, thus putting women at risk for HIV infection from their own husbands. 42% of all new HIV infections in Uganda are intramarital).

As a female Peace Corps Volunteer, my struggle is mainly from issues of harassment. Many Ugandan women (unfortunately) have become used to sexual harassment or even assault, so consider it a normal part of life. For myself and my fellow female PCVs, however, harassment is probably one of the biggest issues we face. It can be everything from cat calls (“Hello baby!”, “I love you!”, “My size!”) and blatant inquiries for sex to sexual assault. I have never been assaulted, but several of my friends have. The emotional effects have serious consequences for us as volunteers – some are afraid to leave their houses for fear of unwanted attention or worse. I find that I avoid most Ugandan men, which is something I wish I didn’t resort to because of the potential for positive, professional relationships. Unfortunately, I’ve heard too many stories of female PCVs thinking that they have great friendships and working relationships with co-workers, only to later be propositioned for sex. I have faced very few issues in my small village – everyone knows me and respects/looks out for me. The main challenges occur when I go to bigger cities.

As a Peace Corps Volunteer, I’m trying to improve the lives of the girls and women around me. I’m going to start teaching life skills (such as setting life goals, communication skills, decision-making, healthy behaviors, etc.) to girls in my community soon. As a health volunteer, I’m promoting family planning options, such as condoms or birth control, to try to curb the high fertility rate of about 7 children per woman, but I believe that the only way to truly reduce family size is to empower women and give them other options in life besides having lots of children. Make sure they get a good education and are able to make their own life decisions, allowing them to pursue a career or envision a different path for themselves, and then they will probably choose to have fewer children. This opinion was solidified after reading Half the Sky by Nicholas Kristof and WuDunn – highly recommended book. Peace Corps Volunteers in Uganda have started an annual program called Camp GLOW – Girls Leading Our World – which is a week of empowering activities for young girls which I hope to be really involved with at the end of 2011; I can even nominate girls from my village to attend. Of course, to empower women, you must involve men and change their ideas about gender roles, so ‘women empowerment’ should involve both men and women. I’m helping to organize and facilitate an HIV/AIDS and Gender Inequality Workshop at my organization, The Hunger Project, to demonstrate the link between the lack of women’s rights in society and the spread of HIV/AIDS. While I won’t single-handedly change the gender roles and treatment of women in Uganda, I hope I can help improve the lives of a few women and girls around me.

Doctors Without Borders (Medecins Sans Frontieres) posts regular “frontline reports” about their work. This is a great example of some of the critical health work being done to prevent mother to child transmission (PMTCT) of HIV in Kenya. MSF is working at the frontlines of pediatric HIV prevalence. There have been amazing medical steps forward to prevent PMTCT, but these innovations are not as easy or accessible in rural regions. Yet another example of the importance of investing in health infrastructure where access is limited and needs are great.

The health care system in Uganda is overrun with problems.  As a community health volunteer for Peace Corps, I have been working with a Health Center II (a basic-services clinic) and have been assessing the state of health care here in Uganda.

While government health care is intended to be free, there are so many hidden costs that patients are often still unable to afford health care.  The government provides free drugs and care, but when those drugs run out (which is all-too-often), the patients are responsible for going to a private drug shop and buying their medicines.  Women who want to deliver at a government health center are often required to bring their own “mother kit”, a set of supplies which can include such things as cotton, gloves, needles, etc.  At our small Health Center II, we have no capability of running tests such as urinalysis, blood smears for malaria, or even taking blood pressure, and often have to refer patients to either a larger government health center or a private clinic for the care they need.  Many people cannot afford even 4,000 Ugandan shillings roundtrip (less than $2) to the Health Center III, a few kilometers away, for testing or maternal care, let alone a trip to a private clinic where all costs are out-of-pocket.  Some of our patients walk several miles to get to our clinic.

Malaria is one of the leading causes of morbidity and mortality, and is severely over-diagnosed.  Practically everyone with a fever is given anti-malarial drugs, and subsequently health centers often run out of the drugs before the next shipment arrives from the government.  The cost of these drugs in a private drug shop can be 15,000/- (about $7), which is too expensive for the average rural Ugandan.  The nurses at the health centers have little choice when they have no way to test for malaria before dispensing drugs – if the patient does have malaria and is not treated, he or she could die.  Better to be safe than sorry, but being safe in this situation causes its own host of problems.

There is also a big problem with motivation among health workers.  Salaries are very low, and some workers feel no obligation to give good ‘customer service’, which is a huge concern in privatized health care systems such as the U.S.  Health workers often show up whenever they feel like it, and leave the clinic hours before the official closing time, leaving some patients to wait for hours to be seen.  A small aspect of this stems from the culture where family comes first – if the nurse has to harvest millet or help a family member out, they don’t see a big problem in staying home.

So what, as a Peace Corps Volunteer (PCV), can I do?  It’s a difficult question to answer – if there were an easy fix, Uganda would have great health care.  PCVs don’t come with any funding or external assistance, we come to act as change agents and co-facilitators to mobilize local resources and work with what is already available.  While it’s difficult to make system-wide changes or improve facilities and equipment without funding, I am working to encourage healthy behaviors, build capacity among health workers, and provide people with the knowledge they need to keep themselves and their families happy.  Another PCV I know is working at the district health office, so he can encourage health officials to improve efficiency and make positive changes in the health care system.  These are small steps, not a big NGO project with millions of dollars backing it, but these small steps are (hopefully) sustainable, using local resources and requiring the community to get involved to make changes in their own lives.

This week’s chosen video highlights the work of HEAL Africa working to rebuild health infrastructure in DRC, address the issue of rape with counseling and support, and train more  health professionals. The organization’s reach is incredible as so is their impact. Eastern DRC has seen so much violence over such an extended period of time and this initiative is having a serious and long lasting impact in the health and well-being of communities. HEAL Africa does more than provide social services, it also builds capacity for long lasting social change in the DRC. Learn more from the video and visit their website.

Across the African continent health systems are greatly impacted by the burden of neglected disease, endemic malaria, HIV/AIDS, and other environmental difficulties. Very often these health crises are exacerbated by the lack of enough trained health workers to administer treatments, provide care, and build the capacity of health systems. Africa Health Placements is one such organization that brings in foreign and local health workers to fill the gaps. Placements are long-term and the needs are real. In 2009, I finished an academic paper titled “Why there is No Doctor” about the lack of health infrastructure, doctors, and the impacts of HIV/AIDS in South Africa.

South Africa has pioneered some of the most advanced medical procedures in the world. In 1967, Christiaan Barnard preformed the first human-to-human heart transplant, but still the majority of the South African population is without adequate health care. Cosmetic and plastic surgery has grown a “medical tourism” industry in South Africa while rural populations wait for doctors.