Author Archives: elizabeth

One Word: Haiti


C2C staff providing high-quality care closer to home

Look Again: Social Business in Haiti

By: Elizabeth Sheehan

When funders gather, they talk about bold and game-changing ideas. That’s what makes funding communities such exciting spaces: like-minded people coming together with shared goals, the financial capacity to make an impact, and a burning desire to see change happen. The best communities are tenacious and think big. As a philanthropist myself, I’ve gained wisdom, grounding, and inspiration from these groups.

But, in recent years, I’ve wondered: Are we intimidated by the thorniest challenges? Are we bandwagon-ing too much? I know what the term “donor darling” says about an organization, but what does it say about us?

For over two decades, I’ve been a member of the Threshold Foundation, a group of philanthropists who pool resources, passions, and expertise to engage in transformative grant-making. Threshold was a precursor to the collaborative philanthropy models that are exploding today and it’s gratifying to see those small, early efforts translated into a large-scale movement. In more recent years, I’ve become a member of Women Moving Millions and a founding community member of Co-Impact and I’m thrilled to see collaboration expected of grantors as much as it is of grantees.

But despite the philanthropic renaissance and re-thinking we are seeing in the world today, I’m continuously dismayed by the reaction I get with one provocative word:

Haiti.

I’ve been funding in Haiti since 2009 and – without a doubt – there are endless lessons and learning that come from a decade of close engagement with Haiti as the nation has struggled to find a path towards health and economic prosperity. I started out making traditional philanthropic gifts to the areas that are personal priorities for me, namely, the health of women and girls. But I quickly pivoted my focus to social business models because, like so many, I saw the pitfalls of traditional aid which – compounded by the influx of earthquake relief money – struggled to deliver real outcomes for people.

In more robust emerging markets, like East Africa, India, and South America, social enterprises are transforming how we think about social impact and how philanthropy can be harnessed to achieve sustainable aims. Big money is pouring into market-based approaches. But in Haiti? Support for social business is anemic.

I’ve had one too many funders tell me that they “just don’t think {insert idea} can work in Haiti”. Largely, these impressions are not based on any facts, experience, economic data, or knowledge of consumer behavior in Haiti.

On the eve of the Skoll World Forum, I am challenging funders and impact investors: look again.

You aren’t going to find easy answers in Haiti. The economy isn’t going to function like the emerging markets that feel safer and more familiar. But the possibility and potential that is burgeoning in Haiti deserves your attention. Social enterprise models are showing results that should make you question the prevailing wisdom that free public services – across the board – are the only future for Haiti. Setting aside the fact that that approach is logistically impracticable, who would pay for that in the years and decades ahead?

Take a look at SOIL’s EkoLakay toilet model that provides an affordable household sanitation solution while employing a cadre of micro-entrepreneurs (bonus: it’s great for the environment). Take a look at how D’Lo Haiti leverages technology and a last-mile distribution model to ensure affordable clean water to tens of thousands. Take a look at C2C’s public-private partnership with the Ministry of Health to get every public clinic in northern Haiti delivering high-quality care at price-points that are lower than current public-sector pricing.

These social business models are leveraging every dollar in new, catalytic ways and – crucially – they’re showing us what the future could look like, where the private and public sectors meaningfully collaborate, and the financial models are dynamic and don’t rely on a one-way flow of funding from the US.

The time is long overdue to look again at Haiti. Join me. Let’s talk.

This entry was posted on by elizabeth.

Innovation Prevents Noncommunicable Diseases

According to the WHO, noncommunicable diseases (NCD), primarily cardiovascular diseases, cancers, chronic respiratory diseases and diabetes, are responsible for 63% of all deaths worldwide. 80% of NCD deaths occur in low- and middle-income countries. While the mortality rate remains high, NCDs are preventable through effective interventions that tackle shared risk factors.

Peter Piot, Director of the London School of Hygiene & Tropical Medicine and Trustee of the Novartis Foundation, recently wrote:

“Health systems in [developing countries] are ill-equipped to address this emergency. They are stretched under the pressure of fighting infectious diseases like malaria and tuberculosis, which still make up a majority of deaths in much of the developing world. It will take decades before sufficient health coverage is achieved that can adequately address the scale of the NCD epidemic. We need a new approach hks1njv.

We can draw some useful lessons from how HIV/AIDS patients were empowered to manage their condition. AIDS was the first experience of managing a ‘chronic’ condition that many low-and middle-income countries had. With the introduction of antiretroviral therapy from the mid-1990s the life expectancy of many AIDS patients increased. Many were able to return to their lives and families instead of being hospital-bound.

Faced with the prospect of having to care for these patients for potentially a very long time, public health systems mobilised to empower AIDS patients to self-manage their condition with appropriate support from their physicians. This shift to a patient-centered approach – taking chronic care outside of the formal healthcare system and hospitals, and into the community and families – has eased the burden of tackling the epidemic and led to precious resources reaching more people.”

This is where innovation in healthcare can contribute to solving the NCD problem. C2C has developed a health care delivery system that is built around patients. Our patient-centered care model is often the point-of-entry to the care system for vulnerable people and families. We respond to local health needs by drawing on communication between the community and the clinic. At C2C, we believe that this approach is fundamental to effective primary care as we help Haitian families get well and stay healthy.

This entry was posted on by elizabeth.

Disruption in Healthcare Doesn’t Work

Entrepreneurs love the concept of disruption in the market. Silicon Valley defines “disruption” as a simpler, cheaper or more convenient alternative to an existing system or product. When it comes to delivering quality healthcare in the developing world, disruption simply isn’t the answer.

Dr. Caroline Buckee said it best in her Boston Globe Op-ed: “When it comes to addressing epidemics — and a lot of other global challenges — the Silicon Valley startup mentality doesn’t work.” Disruption has become a trend in many spaces among innovators. As for the global health care space, we see more grant guidelines calling for this sort of mentality and problem-solving. While it’s important to encourage innovation in healthcare, we should keep in mind that health care delivery, when supported, is an effective solution to saving lives.

As Dr. Margaret Chan, World Health Organization Director-General once said, “a primary health care approach is the most effective way to organize a health system.” At Care 2 Communities, we believe that primary care works. When patients have access to high-quality, affordable, reliable healthcare, it means that mothers are able to care for their children, children can stay in school, and the entire community benefits economically from a healthy workforce.

This entry was posted on by elizabeth.

Marching for Women Worldwide

On an unseasonably warm Saturday morning on the Boston Common, I joined 195,000+ other concerned Americans to show support and solidarity for the principles of the Women’s March. Digging deep into our revolutionary roots (some called it the Boston She Party), we sang, carried signs and basked in the sea of sisterhood. We did not march as sore losers in the political election but stood together to protect fundamental human rights and that includes the rights of all women.

Ten days earlier, I joined a film crew in Haiti to document the story of C2C’s head nurse, Herlande Duvot. As one of the first C2C employees in northern Haiti, Herlande’s success story has been an integral part of C2C’s success story. She is a clinician and a thought leader, helping us build a sustainable model for community health. A cornerstone of C2C’s mission is access to reproductive health care and Herlande manages C2C’s family planning and women’s health programs – the very services that are under threat in the U.S. Although the Haitian Ministry of Health tries to provide free family planning products to its population, it often falls short due to transportation, supply, and logistical issues. This is where C2C steps in: we prioritize family planning for women and ensure that health care services, education, and products are available to both women and men.

On January 21st, I locked arms with women I had never met on one side and members of my faith community on the other. I felt supported in doing the hard work of protecting fundamental rights in a changing world. I have always known that women in Haiti want the same opportunities we want for our children here in the U.S., but when they struggle to access family planning services, choices can be hard. So as I marched to protect the rights of my daughter, myself, and millions of other Americans, I also marched for women in Haiti knowing that polices made in the U.S. will trickle down to affect them too and we will continue to march until all women can keep their bodies safe and protected.

This entry was posted on by elizabeth.