We Have Seen What These Women Can Do

When you travel in Northern Kenya, you see poverty. Deep, painful poverty.

But when I meet with the women in our program, I see something else. In their beaming faces, I see the pride of accomplishment and the freedom to determine their own future. They are the picture I carry in my heart—a picture of hope.

In September, I met with a young woman named Marsogoso in the rural village of Matarbah. (You can see Marsogoso and her children in the photo below.) For me, Marsogoso illuminates what it means to be poor, but still live in hope. I wanted you to meet Marsogoso … through her own words: 

“Mama Rungu, we know the sun is getting harsher, but we want to say thank you.

When this money was given to us, we got confused. We were worried. Be careful! We thought BOMA would take us to police if we wasted this money. We put the money in a box in a box in a box. We used half to buy things for our shop and saved half. Then we became experts. The savings box helped us relax. Now we save every week and it has really helped us.   

At first, when we started this business, the men and the elders were mocking us. We would take the lorry to Marsabit to buy stock for our businesses and the men would say, ‘These women.  What are they up to?’

Here is my mother. She is here [in the business].My father raises livestock. He wanted to send my brother to school, but there were no buyers for our goats. 

My father came to me. ‘Girl, is there anything out of this thing you are driving?’

So I went to my group to ask them if I could take money from our business group for school fees.  We were not sure that this was right. So we went to Judy and Ali [the BOMA Village Mentors for Kargi] and asked them, ‘This money belongs to BOMA.Can we use it for this, for school fees?’

Judy and Ali told us that this is the best thing to support.  

This is when we supported a loan for school fees and my brother, this boy, went to school in Isiolo. 

Then my father went to the shrine in the middle of the village. He told the men, ‘We have seen what these women can do. Please tell the men of this village to support their women who are in these businesses.They should show them respect.  No man should underestimate the strength of these women.’”  

I believe that the sentiments of this blessed season—joy, faith, love and hope—are possible when we commit to the well-being of another person. I believe that small acts can inspire moments of transformation, even in small villages in remote Northern Kenya. 

Wishing everyone in the BOMA family all the blessings of the season. Image

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The Solar Generation

“Mama Rungu, I am worried about you,” Neiboticho Wambille told me.  “I have some sour milk for you, you must drink some.”

“Acho olang, Neiboticho, I am fine.  Just very hot.”

I was sitting with Neiboticho and her business partners under the shade of a small acacia.  They proudly told me about their substantial monthly deposits in their savings box.  It was a remarkable achievement since they only started saving after the training program in October.  I had come to visit with Neibotochio because I wanted to ask her about what she had said at that meeting.

Kura had told me about Neiboticho – he was so inspired by Neiboticho’s comments that he had called me on the satellite phone the night after the training.  “Mama Rungu, there was this old woman, and during the training she stood up and said something really amazing to the rest of the group.”

David duChemin's incredible photos capture the lively spirit of Neiboticho Wambille

David duChemin’s incredible photos capture the lively spirit of Neiboticho Wambille

She said, “We Rendille, we have forgotten how to save.  A long time ago we would save part of the goat leg for the times when there was drought, or when we would have little to eat.  Then we would make soup and our children would not starve.  Now that we are more modern, we have forgotten the old ways.  BOMA has come to remind us of what we used to know.  We must save for the times when life is hard.”

Everyone was very inspired by Neiboticho’s words and it was wonderful to hear her repeat them.  As the sun blazed down through the leaves of the acacia tree, more people joined us, including some of the younger BOMA business women.  Neiboticho kept talking, “This younger generation, they do not remember the old ways.  Now they do everything quickly.  They are the solar generation.”

I looked at Kura, “Solar generation?”  I did not see any solar products in the village.

“She means all the shiny things that the young women put on their clothes and beads,” Kura told me.  It was true, one of the young women had shiny metal discs hanging from her beaded necklaces.  She had on a goat skin skirt but her shirt was a gold fabric with shiny flat beads that made the shirt shimmer in the bright African light.

I asked the young woman, Khona Wambille, what she thought about the fact that the Rendille were not as nomadic anymore.

“The main reason the older people know about the goat leg is because they were living far from everything.  They used to rely on goat legs and milk.

Now we have settled near a town and we can buy food.  We can also get relief food when there is drought.  Things are more modern near the town – it has water so that we do not have to walk long distances.  Our children can go to school.  It is also safer in town.  When we were nomadic we lived by ourselves – each clan had their own area – and we were far from town.  Then there were attacks by the Gabbra and I remember a time when they killed a child and an elder. Then we all ran away.  Some ran to Korr and some came to Kargi.”

“Since that time we have been here.”

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Hot Nights and the Witch Doctor

We left the village of Merrille feeling good about our new Mentor, Christopher Lepaati Meselin.  Engaged and passionate about his work, Christopher covers a large territory and shares our commitment to reach out to the women in the outlying nomadic villages where there are deep pockets of extreme poverty.  Some days Christopher walks 4 to 5 hours each way to either enroll new women in our program, to mentor existing businesses or to deliver training programs.  I was sorry that we only had time to visit with some of the new businesses in the main village as we had a long day of travel ahead of us, but our visit with

BOMA;s Mentor in Merrille, Christopher Meselin, meets with the Naratengai Business Group, who run a butchery

BOMA;s Mentor in Merrille, Christopher Meselin, meets with the Naratengai Business Group, who run a butchery

Christopher reaffirmed my belief that the success of each business we launch is directly related to the commitment of our BOMA Mentors.

As we departed Merrille, Kura asked if we wanted to visit with the local witch doctor.  When we were planning this trip with David and Corwin, it included David’s return visit to his adopted Rendille village of Ongeli and to a woman, Ntoijoni Ngosoni, who had identified him as her own.  Kura had received information that Ntoijoni was quite sick and was staying with the witch doctor in Merrille.  She had now returned home to prepare for David’s visit, but Kura felt that is was important that we stop by and pay our respects to Lkanikis Leaduma who is officially referred to as the Laibon, a healer.

As we drove through the sand and acacia trees adjacent to a dry river bed, we could see the Laibon’s village on the other side.  Kura skillfully drove Gumps over the large, sharp rocks – the only route to the Laibon’s home.  We pulled into a semi-circle of buildings that consisted of a building and an adjacent large hut for the Laibon that looked out upon a random collection of older huts, most in a state of disrepair. The huts looked temporary and were clearly not built with the same skill as traditional Ariaal or Samburu huts.  The patients were mostly older men who were seated on small stools or stood tall and thin, leaning against the trunks of thin trees that provided little shade.  It was a hot and sad place.

The Laibon greeted us warmly and invited us inside his hut for a visit.  It was hotter inside the hut than outside.  Kura and I sat on the bed with the Laibon who brought out a package of pictures.  I was surprised to see a picture of a book that I had received just days before I left for Kenya.  Our Laibon had a long family relationship with Dr. Elliot Fratkin, Smith College professor of anthropology and author of one of BOMA’s most important reference books, As Pastoralists Settle.

We asked about the patients, and the health of Ntoijoni.  The Laibon told us that he was not able to do much for her.  Every day he put herbs on her legs and chest to bring out the ailment but she continued to waste away.  While Ntoijoni’s condition was different, it was obvious that many of the male patients were HIV positive and this was a last stop for them.  We exited the hut but then the Laibon called Kura and I back to sit on his bed.  He told us that many of the patients were too poor to pay him anything and he also had to feed everyone.  He asked if I could make a donation to help him in his work and I pulled out some shillings from my bag.  The Laibon quickly put the money in his kikoy and then took my hand in his, rotating my palm back and forth and then he spit on my palm.  With his other hand he made some signs in the air, bestowing on me special blessings.

We arrived at the Isgargaro campsite late in the afternoon. Despite our reservation (strictly an idea in northern Kenya) a group of CARE surveyors had taken most of the huts.  There was enough room for a few of us, and the rest of the staff would have to use our one tent.  Omar started boiling water for tea as we negotiated with the women who run the camp.  Eventually additional space was found and we settled into the dark of the night.  This used to be one of my favorite places to stay but the beds, made of lashed together sticks and old mattresses, are slowly sinking into the rough dirt floors thanks to the munching of termites.  I dreaded the trip to the latrine that was crawling with hundreds of cockroaches.

Omar cooked a meal of goat stew, cabbage, carrots and rice.  Semeji went into the village and found a few Tuskers for David and Corwin.  The air was still and hot and the Tuskers hotter.  “I’ve never burned my lips drinking a Tusker beer before”, Corwin remarked.

It had been a long day and I returned to my hut to try and sleep.  A basin of water was waiting for me and I dipped a long scarf in the cool water.  I lay down on my bed and draped the cool wet scarf over me.  In the morning the scarf was dry and my sheets were soaked with the sweat of a hot sleepless night.

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We Will Educate

The rainy season is the most dangerous time, the women of the Nkilepu business group told me.  I didn’t understand.  The rainy season is what everyone hopes for.  It brings accessible fresh water; the grasses start to grow and the cows and goats are once again healthy and strong.  The females become pregnant and have more cows and goats, increasing the wealth of every family.

The business partners of the Nkilepu business group in the village of Ndikir.

The business partners of the Nkilepu business group in the village of Ndikir.

“It is because of the warriors and the shifta,” they told me.  “Our village is remote – over five hours walk to Laisamis village where we buy the stock for our business.  In the rainy season the bandits can survive for long periods of time when there is water in the bush.  For us, it is very dangerous.  They attack us, stealing our stock and worse.”

I turned to Meshack, BOMA’s Field Officer, and remarked that we keep hearing this over and over.  The greatest challenge for many of our business groups is access to a larger town where they can buy goods for their business.  When we visit businesses that have easier access, either through proximity, better security or the availability of lorries that can provide rides, then we see much larger and varied stock.  But that has not stopped the business groups in the village of Ndikir.  Their savings association is just a year old but they have over 74,600 shillings in savings plus loans of 12,000 out to members.

“Do you ever loan money to your husbands?” I asked the women.

“No,” Ngusulia Arabolia told me, “We don’t allow them. They never pay us back.  We only loan money to women like us who want to educate their children.  We all have respect for each other because we all want to educate our children.  This is money they are grateful for and we know they will pay us back.”

These women were so committed to education that it had led them to challenge the male elders in their village.  Ngusulia’s face was animated as she told me about a recent incident when the elders of the village took five children out of the local primary school.

“They just removed them from school because the elders know that If the children are educated, they will not follow them.”

So Ngusulia and her business partners made the dangerous walk to Laisamis village and reported the elders to the district education officer.  The five elders were put in jail for their efforts.

One of the questions that we often ask ourselves is what does an economically empowered woman look like in northern Kenya.  Sitting in that dark, hot hut, I realized that these women were the face of empowerment.  They were committed and determined to educate their children.  They take great risks to ensure their economic independence from their husbands. And they are becoming important role models for their daughters.

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Poverty is the Worst Form of Violence

Mahatma Ghandi said “poverty is the worst form of violence.”

That violence manifests itself in Northern Kenya through people who have poor nutrition and a higher risk of disease. They have a lower life expectancy and inadequate access to healthcare. For children it is poor school attendance and limited achievement, and for adults it means recurring disabilities and listening to your hungry children cry themselves to sleep.

In 2005, a census by the Government of Kenya found that 91.7% of individuals in Marsabit District are living below the National Poverty Line, making it the poorest of the 69 districts in Kenya (National Bureau of Statistics 2012). Apply that same demographic to an area the size of New England and you understand the scope of the disaster that we face.

Reversing the trend of poverty can only come through an individual’s ability to acquire new skills and learn adaptive behaviors. Climbing out of poverty is hard work but through resourcefulness and resilience it is possible.

Epori, Aipa and Achukudu, brave BOMA entrepreneurs who are HIV+ and raising their children alone.

Epori, Aipa and Achukudu, brave BOMA entrepreneurs who are HIV+ and raising their children alone.

That challenge is especially difficult if you are HIV+. While in the village of Loiyangalani, I met with a group of women whom we have recently enrolled as new entrepreneurs. Epori Lokitir is one such person. The government of Kenya provides her with free anti-retrovirals for herself and the youngest of her four children, who is three years old. She told me, “I used to be idle, waiting for people to help me.  Before I had this business, I would take my medicine and my whole body would shake because I did not have enough food to eat. But now I can buy meat and I feel better.”

Aipa Kiboko has an even greater burden. When her husband found out that she was HIV+ he abandoned her. He has never been tested. Then her sister died of AIDS and she had the additional burden of not only caring for her three children (the youngest is HIV+), but also for her sister’s four children (the youngest is also positive). She told me, “I want all of my children to go to school. And I want them to look good. Now I can buy detergent so that we have clean clothes and I can even buy hair oil for my children.”

As she described her life, Aipa let the tears flow. I asked the group of women what gives them hope. “We want more training,” they told me. “We want to learn more so that we can do more business and improve ourselves.  It is up to us now.”

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The Savings Group and the Wife Beater

Maria Lesiil is the BOMA Village Mentor in the Northern Kenya town of Archers Post. She is beautiful and charismatic and held the attention of more than fifty women for the five full hours of the savings training session. About two hours into the training, the women took a break. Helpers poured milky white tea from large jerrycans into cups that were shared. Then the women were invited to break out into their savings association groups.  Each savings association is comprised of four to five business groups and the women had made their decisions about this important partnership prior to the training. Much of it was based on geography, as many of the women came from villages as far as twenty kilometers away.

BOMA Mentor Maria Lesiil leads a savings training program in Archers Post.  The three-lock savings boxes are at her feet.

BOMA Mentor Maria Lesiil leads a savings training program in Archers Post. The three-lock savings boxes are at her feet.

As I sat making notes I heard one savings group laughing hysterically. Something was obviously very funny. Maria checked in with them and then came over to me to explain: “One of the women in the group is disabled – her leg is very bad, so she limps.  Her husband is a bad person. He always beats her, but he never hits her good leg because he needs her to keep her BOMA business going. One of the other women told her that she must make her husband stop beating her. But she told the women that she could not, because her husband is too big and too mean and he drinks. Then one of the other women told her that “We are a group now. We will chase him off. He is not bigger than all of us.” And the women laughed and laughed at the thought of them all chasing this mean bully away from his house.

The day ended in song – a song of prayer and blessing. The women came forward to Kura and me in pairs, dipping their heads towards us with the call of “Supa!”

As we made our way to the vehicle, Senteyo Lenayasa came from the building across the dirt path to meet us. She also had a BOMA business in the village of Unity, and one of her business partners was in the hospital. “Do you mind if we come visit her?” asked Kura.  “Not at all. She is feeling poorly, but I know she would like to see Kura and Mama Rungu.”  We walked over to the Catholic mission hospital and visited with Nchekiyo Lembwakita.  She lay on a nylon covered mattress with a nylon pillow under her head. A mosquito net hung above her head. Deep circles ringed her eyes and her face was gray.

“Pole,” I told her, “Sorry you are not well.” Senteyo told us that she had a pain in her abdomen, and that if it were not for this business she would not be able to come to the hospital. I sat with Nchekiyo and held her hand. She smiled weakly. While I am sorry for her suffering, this is also a picture of success: being able to receive medical treatment for when you are sick, instead of waiting until it gets more serious.

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Under the Shadow of the Sacred Mountain

With the first pale light of dawn, I wake to the sounds of a Northern Kenya morning. Wrapping my kanga around my shoulders, I hurry out to the verandah of my tent to watch the day begin. As I sit in my cushioned chair, wild bees murmur in a tree nearby and lizards and insects start to stir in the thatched roof above my tent. In five minutes I count more than 20 species of birds – weavers and bulbuls and hornbills.

The heat starts to rise from the valley floor below the mountain and soon the far landscape becomes a smoky haze. A gentle wind starts to pick up. Daniels arrives with a wicker tray of hot water, hot milk and a small bowl of dried instant coffee.


Our tented camp is at the base of the sacred mountain of Ol Lolokwe, also called Sabache.

Sabache Camp is in the shadow of Sabache Mountain. The mountain is also called Ol Lolokwe and it is situated in a beautiful forest alongside a lugga, a veined depression in the side of the mountain where the rainy season spills its wealth over giant boulders, leaving pools of green when the rains stop. On our arrival yesterday, the pools were alive with the melodic sounds of frogs and as the sun set their chorus grew louder. During the night their calls would suddenly stop and there would be dead silence. As I lay in my cocoon of netting and canvas, I wondered what predator visitor could halt their calls. I tried to stay awake so that I could hear other sounds that the frogs had drowned out – the cough of a leopard or the silent footfalls of Aribo, who was diligently patrolling the pathway between our tents.

Kura remained back in Archers last night, so he could be up early to go to Isiolo and withdraw the money for the second grant distribution to the twenty businesses that we have launched in the area. He left me with BOMA’s vehicle, Gumps, and after breakfast I drove us back to Archers, with Aribo riding shotgun. We were looking forward to seeing BOMA’s Mentor in the village, Maria, who would be overseeing the public distribution of grant funds and lead a training session on savings. I will be the silent observer.

Participants in the training program were requested to arrive by 9 a.m., but when David, Corwin and I arrive, the session has yet to start. Maria was busy trying to locate one of the Catholic sisters who had the key to the training hall that we rent. We went over to a local campsite along the rushing waters of the Ewaso Nyiro River where we could sit in the shade and I could access good network and charge my laptop. Finally Kura called and everyone was ready.

More than fifty women were seated on the perimeter seats that surround the hall. I went around the room and shook each of the women’s hands, saying hello and smiling at the numerous babies who were nursing or seated on their mother’s laps. I recognized many of the women from previous visits to Umoja and Kiltamany villages. Maria asked me to say a few words and she translated into Samburu.

And then the training session began.

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Welcome to Kenya B

There is a Kenya A and a Kenya B.  If you were to divide the country in half, Kenya A is everything south of  Eldoret in the west and Isiolo in the east.  Kenya B is to the north – stretching from the border of Somalia to the east and South Sudan and Ethiopia to the north.

St. Dominique Saviour School, Manyatta Lengina Village.

No building, no books. A volunteer teachers provides instruction to a group of students in northern Kenya. This is what Kenya B looks like.

Kenya A has schools with textbooks and hospitals and paved roads and public transport.  They have cell phone networks and banks and post offices.  Kenya B has school buildings (if they are lucky) but no textbooks.  Many of the schools are a chalkboard leaned up against a tree that provides shade for the students and the volunteer teachers who receive no pay.  Health clinics can be as far as 300 kilometers away but most of the towns simply have a government dispensary providing aspirin, malaria treatments and rehydration meds from the bad water that brings constant bouts of life-threatening diarrhea. When cholera strikes like a death wave, it is the residents of Kenya B who have no recourse but to sit and watch their loved ones die.

Today we passed from Kenya A to Kenya B.  We made the customary stop in Isiolo to pick up the last of our supplies and do the final checks on our two and cruisers.  We then embarked on the short journey to Archers Post, where Semeji, BOMA’s security man, picked up his AK47. It had been checked at the police station.   Guns are not allowed in Kenya A, but Semeji is a recognized home guard, authorized to carry a gun to provide his community with protection since Kenya A does not see the value in signficant investments in security or a justice system for Kenya B residents.  We also picked up our second security guard, Aribo, whose name in Samburu literally means savior.  He has a G3.

Kura and I are spending two weeks in the field, checking in with our mentors and the women who are now running small businesses that BOMA helped them to establish with grants, training and mentoring.  We are joined by the generous presence of David duChemin, a humanitarian photographer who traveled with us two years ago thanks to a gift from a donor.  Now he is coming back, as his gift to us, and he is joined by Corwin Hiebert, his best friend and manager.

Kenya B is not all hardship.  For our first night as we head north, we are staying at Sabache, a new tented camp on the flanks of a mountain of the same name. I’m sipping my Tusker, listening to the melody of frogs who inhabit a nearby pool.  A group of warriors are perched on their haunches on the other side of my tent, attending to cattle that are shiny and fat.  This is also Kenya B.  When it is green, everyone is happy.  And I have never seen Kenya B so green.

It is a good start to our journey.

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This Water Belongs in Mombasa

It is inevitable that Kura and I would eventually become increasingly removed from the day to day work that happens on the ground in our region in northern Kenya.  BOMA now has a new field officer, Meshack, who works closely with our Mentors and businesses and Kura is now assuming more responsibility in our Nanyuki office as our Program Director. With over 1000 businesses established and 32 employees in two countries (90% in Kenya), our efforts now include keeping the overall enterprise functioning so that it efficiently continues to deliver our poverty graduation program.  We have accountants and auditors and payrolls and reports.  And like most non-profits, there are few large repeat sources of funding.  So every year you restart the clock, looking for funds that will support the heart of what we do – help some of the poorest women on the planet start small businesses so that they can feed, educate and care for their children.

Kura and I had planned this trip a few months ago.  No matter how many written reports you see, no matter how many meetings we have, I have to talk to the women myself to see how their lives have changed.  Every person has a story to tell and I want to hear theirs.  I want to dig deeper and spend more time understanding what an economically empowered woman from northern Kenya looks like. I want to invest most of my time listening – still the greatest investment that we made when we started our work.  Now, it is the women in our program who are teaching us and we still have much to learn.

It won’t be all work – during our journey we will have time to revel in the beauty of this raw, rugged land – from a swim in the jade sea to falling asleep to the whoops of the hyenas to taking that long-awaited sponge bath by the light of the moon after a long hot day of dust and mud and travel.

Could be dust, could be mud

There will be challenges too.  The story of northern Kenya is usually about drought, but for the past few months the rains have been generous.  The dust and sand that we are accustomed to has now become wet cement and lorry swallowing potholes.  I expect that part of our destiny will include getting stuck, changing tires and digging out vehicles over their axles in mud.

All of it to tell us that no matter what we do, no matter how hard we work, we can never control it all.  There is a great moment in the movie Out of Africa where Karen Blixen is trying to create a dam for her farm.  Farah Aden, the head of her household, keeps trying to tell her that she must not try and stop the flow of water.  “This water belongs in Mombasa…” he tells her.

At the end of the movie, as she deals with another round of crisis’ that includes a deluge of rain, the dam breaks and she finally tells the workers, “Let it go, let it go. This water belongs in Mombasa.”  And so maybe this trip is when we also let it go just a bit. Let life take its course and we just sit back and let the women of northern Kenya tell us how the story goes.

Posted in African women, Economic empowerment, Northern Kenya, REAP (Rural Entrepreneur Access Project), The BOMA Project | Tagged | 1 Comment

Inspired by Dr. Paul Farmer

I am always humbled by what women tell us after they start earning an income with their new BOMA businesses.  During a recent visit to the village of Ilaut, a woman named Nkaroni told us, “Before, I could not rest. I was running everywhere, looking for food. But now my kids can eat something. My kids are not starving anymore.”

You cannot work in northern Kenya and not be witness to the protruding ribs and distended stomachs of malnutritioned children. Yet it is still difficult for me, as a mother, to comprehend what it must be like to wake up each day and fight to feed your children.  All across the arid lands of Africa (40% of the continent) women like Nkaroni wake up every day and worry about food for their children. Some philanthropists would say that the intractable cycles of drought, conflict and famine are so immense in these areas, and the solutions so expensive and risky, that they are not worth the investment.  Some donors prefer to invest in more “cost-effective” solutions that lead to a vision of First World success, where university educated entrepreneurs start businesses that employ hundreds.  “Poor women in urban environments are just a better investment,” one potential donor told me.

This is why BOMA fights for the Nkaronis of the world.  Every day we compete for donor funds that will fund training, mentoring and seed capital grants that replace short-term solutions like food aid with business income.  Some donors tell us that you can’t simply give poor people money.  Instead, they say, we should make loans so that our participants “have some skin in the game.”  But if our women squandered the seed capital grants that we give them to start a business, then why are 97% of our businesses still in operation at three years?  BOMA women are earning a sustainable income and providing for their children. Businesses are distributing profits and accumulating savings within two months of start-up, a statistic that no micro-lending program can claim. With the right training and mentoring support, poor women, we argue, are a great investment of donor funds.

After an initial investment in a three woman business – $250 in seed capital, training and mentoring – women like Halhalo and her partners have over $2000 in business assets and savings at three years.

So our battle is more than a fight for foundation grants and big donations. It is a fight to challenge fundraising trends like “impact investing” that ask program participants to pay for the programs benefiting them, either through interest payments or pay-it-forward strategies.  We compete for funds in a world where rich women philanthropists invest millions of dollars in women leaders, fancy award ceremonies and documentaries, but leave the communities that surround them still destitute.

That is why I am so inspired by the work of Dr. Paul Farmer, the anthropologist and physician whose public-health initiatives in Haiti were documented in Tracy Kidder’s best-selling book, Mountains Beyond Mountains: Healing the World: The Quest of Dr. Paul Farmer. Farmer is widely recognized for fighting the HIV/AIDS epidemic in Haiti and Rwanda, and is the founder of Partners in Health (PIH), an organization dedicated to providing comprehensive health care to poor communities around the world. (PIH’s co-founder, Jim Yong Kim, is now head of the World Bank.)

In a speech at Yale Divinity School last spring, Farmer said that in the mid-1990s “we started fighting for access to care. There’s only one standard of care, only one intervention that’s going to alter mortality in HIV infection, and that’s these drugs. And it was a long struggle. It was a huge debate. Our peers—policymakers, international health experts, even physicians, I’m a little embarrassed to say—were saying, ‘Well is it really cost-effective or sustainable to use these drugs in resource-poor settings?’”

Farmer had to fight against the “religion of cost-effectiveness.”  He believes that poor patients are entitled to the same level of care as rich ones.  And he believes that this fight is not just about healthcare.  It is about poverty and social justice.

So I take heart when foundations tell us that our model is not “high-impact” because we don’t have a revenue strategy.  Or foundations tell us that they’ll fund us this year, but next year they want to see us do something different (why?).  Or funders that tell us that they wish we had a strong story-telling component to our model (Hello? Have they paid any attention to what we say and how we say it?).  Most of these funders want to see success in First World terms.  I once had a fairly sophisticated donor tell me, “I’m really not interested in saving a bunch of starving people.  I’m not interested in a program that has poor people selling stuff to other poor people.” Another donor told me, “Why don’t they just move?” This person had obviously never been to the slums of Nairobi, where most rural migrants end up.

Donations to organizations like BOMA, which works on the front line of extreme poverty, used to be about charity and humanitarian empathy. Now too many donors seem to be focused on cost-effectiveness and a return on investment.  In a world of limited donor funds, I understand this trend, but we’ve lost something in the process. When Farmer sees someone who is suffering he would say that we must do whatever it takes to relieve the suffering of that one individual.  He said, “For me, an area of moral clarity is: you’re in front of someone who’s suffering; and you have the tools at your disposal to alleviate that suffering or even eradicate it; and you act.”

So that is what we do.  We act. We may not receive the big multi-year grants or the big awards, but we can offer what many of these programs cannot: impact.  We have measurable outcomes that prove our program of income diversification works.  It is one of our best tools in the fight against the ignorance and prejudice of donors who think that poor people cannot be trusted with cash.

Oh, and that issue of cost-effectiveness?  We’ve got that too.  But it’s not what we stand for.  Our number one commitment is to help those who suffer the most.  And maybe someday we’ll find that foundation or philanthropist that says to us, “We value every human life, even the poor ones that live in impossible circumstances.  We’ll join you in this fight and we’ll be with you until you get the job done.”

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