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Sex Deprived? So, Rape Thy Comrad.

February 17th, 2011

“‘Battle buddy bullshit’ said García from the Military Police. ‘I didn’t trust anybody in my company after a few months. I saw so many girls get screwed over, the sexual harassment. I didn’t trust anybody and I still don’t.’” [1]

In my introductory post I promised to look at the many ways war affects women’s physical and mental health and the role the media plays in spreading awareness and empowering women in difficult situations—so far we’ve examined rape as a tool in war, the hidden gender-war on the Mexican border, and the sweeping effects of social and mainstream media—now it’s time to turn to a new lens: women in modern warfare. In the midst if all the ROTC talk on campus, I figured, this would be an interesting exploratory piece for the week. It may appear strides have been made, as women increasingly choose to join military ranks along side men, but the story is much more complex. An excellent piece, written in the midst of Bush’s troop surges in 2007, titled “The Private War of Woman Soldiers” by Helen Benedict explores this exact theme with a unique twist: rape in the military.

After having interviewed over 20 female soldiers in Iraq, Benedict notes, “I can’t help wondering what the women [in the troops] will have to face. And I don’t mean only the hardships of war, the killing of civilians, the bombs and mortars, the heat and sleeplessness and fear. I mean from their own comrades — the men.” [1]
The threat of rape was so bad, women were warned by their officers not to go outside at night nor to enter shower facilities alone without other female companions for security. [1] This suggests several things: first, that the trend of sexual violence is all too real in the US military; second, that the authorities are aware of the regularity of these violations and unwilling to respond; and third, that this sets a dangerous precedent for women entering military service and for the nature of relationships amongst the genders within combat troops. Danger in war should not come from the home base—the last fear that a US soldier should deal with is the threat of his or her own side. Yet, as Spc. Mickiela Montoya, age 21, member of the National Guard in 2005, explains, she took to carrying a knife with her at all times. “The knife wasn’t for the Iraqis,” she told me. “It was for the guys on my own side.” [1]

In a time when going to war is low on the list of priorities for young American generations, there has been a trend to waive violent ad criminal records of enlisted army members—it seems the government is side-stepping laws meant to protect soldiers in an attempt to increase military participation and fight off soldier burnout rates. Consequently, these delinquent soldiers pose an increasing threat to the safety of other army members, particularly women.

Sex and war are a very tricky equation. Soldiers have been known to abuse and misuse foreign females for their own pleasure and carnal desire and (as discussed by several blogs from this course) have fueled the growing sex trades in the countries where they are stationed. As more women than ever before enter the US military service, our nation has to think about how we protect these brave individuals from falling victim to sexual violence in the midst of war.

The rape situation in Iraq became so bad that in 2004 former Defense Secretary Donald H. Rumsfeld ordered a task force to investigate. The statistics remain largely unavailable, but women’s stories are becoming more accessible. Col. Janis Karpinski publicly released that one of the reason several women soldiers died of dehydration was because of fear of traveling to watering centers due to the ever-present threat of rape from their male troop members. [1] In effect, she risked losing her high profile military position because she dared speak out against these offenses. Her superiors threatened her on the charge that she was “bringing attention to the problem” [1]

What astonishes me is that these stories never struck big in the media—it is as if little action was taken to curtail these incidents in order to protect US army’s reputation and to avoid discouraging enlistment. When NPR ran a story on wounded soldiers focusing on women in the Iraq war, they did indeed explore the effects of changing warfare on a growing female military front. It was noted that women fighting in the Middle East make up approximately 15% of troops. [2] While this is still a minority group, it is a larger fraction than has ever before been observed. The article also looked at growing casualties, 1500 US personnel dead by 2005 [2] –and as we all know that number steadily grew.

The NPR piece notes that the nature of modern war is such that all soldiers are always on the front lines, because there are no clear distinctions. Women are in the combat units, despite formal restrictions. As a result women are facing the same wounds and traumas as their male counterparts. [2] There is no gender distinction when it comes to battle.

What this detailed history of women in combat failed to examine, however, is how the changing demographics of the military play out internally. In fact, few pieces covering the war did this. If they had, they would discover a story of perpetual abuse.

Why does the media not care to inquire about these abuses and the stories behind them, so that we can safeguard the lives of women risking themselves for our nation. Even Rumsfeld had taken note of the rising trend, as he ordered the elusive investigation– so how did this slip from the media’s eye?

I was shocked to read Benedict’s piece, and to hear that American soldiers live in fear within their own side’s safe zones as victims of more than just the external enemy, but also the internal “domestic” enemy.

Benedict’s investigation ends on a very somber tone, she concludes, “If this is a result of the way women are treated in the military, where does it leave them when it comes to battle camaraderie? I asked soldier after soldier this, and they all gave me the same answer: Alone.”

We need to start nurturing the physical and mental well being of our soldiers and ensuring that women are provided the necessary protections to serve their nation, not alone, but as part of the US team.


[1] Benedict, Helen. “The Private War of Women Soldiers.” Salon. 7 Mar. 2007. Web. http://www.salon.com/news/feature/2007/03/07/women_in_military.
[2] “Wounded in War: The Women Serving in Iraq : NPR.” NPR : National Public Radio : News & Analysis, World, US, Music & Arts : NPR. Web. 18 Feb. 2011. http://www.npr.org/templates/story/story.php?storyId=4534450.

Fighting Political Instability with Female Economic Empowerment

February 17th, 2011

Throughout the world, political instability causes innumerable problems for international security. Failed states like Somalia and poorly governed states like Pakistan are breeding grounds for dangerous actors. For example, Somalia has become the number one state responsible for piracy on the high seas. Similarly, the ungoverned regions of Pakistan, like the Swat Valley, are the strongholds of extremists, such as the Taliban, that launch attacks on both the Pakistani and Afghan governments. Therefore, if the United States is to address a major root cause of global instability, it would do well to focus on the problems of political instability that many states face.

One major factor in political instability is income inequality. It was well documented in a study in 1996 that political instability, often manifesting in violent protest or unrest, is significantly influenced by disparities in income distribution.[1] Their causal logic is fairly straightforward. When there is a large gap between the wealthy and the rest of the population, the social fabric of society is much weaker. The groups separate not only in wealth but in political status and importance, feeding unrest. In fact, the recent overthrow of the government in Kyrgystan and the uprisings in Tunisia and Egypt were preceded by food shortages and general lack of economic opportunity for the populace.[2][3] In an ironic twist, economic development is also adversely affected by income inequality. A World Bank report on the issue outlines a couple important factors for this link. When there is a high level of inequality, it becomes difficult to reach political compromises between the wealthy and the poor, which further decreases the likelihood for investment in the country. Additionally, high inequality lowers the levels of trust and commitment necessary for enterprise by increasing the risk associated with business transactions.[4] In light of this evidence, combating income inequality should be an important goal for governmental policy.

One important way that income inequality can be reduced is through female empowerment in the workforce. It has been shown that women entering the work force in developed nations has contributed “more to global GDP growth than have either new technology or the new giants, China and India.”[5] Women have provided the energy and new ideas that have spurred vast growth in these countries and these results can be replicated in the developing world. Nevertheless, there are numerous barriers in place preventing women from expanding their economic impact. Strict gender roles and various patriarchal instruments are large hurdles for women in many developing countries. A study in the World Economic Forum demonstrated a significant correlation between sex equality and GDP per capita.[6] This is a telling finding. Furthermore, Denmark and Sweden are often viewed as two of the most stable governments in the world and they top the charts for female employment percentages. They also are two of the most equally countries when it comes to income distribution. These links are not random. The developing world, and much of the developed world, should look to these nations as excellent models for policy in the future. As gender equality increases in all states, there will be a great spurt of economic growth creating economic opportunity for both sexes which in turn will lead to better results for political stability.

[1] Alesina, Alberto and Robert Perotti. “Income distribution, political instability and investment.” European Economic Review. Vol. 40: 6. June 1996. pp 1203-1228.

[2] Dzyubenko, Olga. “Kyrgys troops break up crowd, see coup attempt.” Reuters. www.reuters.com. Aug. 5, 2010.

[3] Whitaker, Brian. “How a man setting fire to himself sparked an uprising in Tunisia.” The Guardian Online. guardian.co.uk. Dec. 28, 2010.

[4] “Income inequality.” World Bank Group. http://www.worldbank.org/depweb/beyond/beyondco/beg_05.pdf

[5] “The importance of sex.” The Economist Online. www.economist.com. Apr. 12, 2006.

[6] “A guide to womenomics.” The Economist Online. www.economist.com. Apr. 12, 2006.

TBAs, Technology, and the Maternal Referral System

February 17th, 2011

Last week, Jenna pointed out (here) some of the limitations of Traditional Birth Assistant Training programs. While some TBA training programs have shown benefits – for example by improving hygiene conditions at TBA attended births[i] – many have shown disappointing results. One of the major causes of disappointment in TBA training programs has been the realization that the referral link between TBAs and hospitals often functions poorly. The reasons for this are two-fold. First, some studies have indicated that training TBAs to identify obstetric emergencies does not necessarily increase referral rates.[ii] Secondly, as Jenna mentioned last week, there is often insufficient time to transport women with obstetric emergencies to tertiary care facilities.

The ability of traditional birth assistants to respond to obstetric emergencies is inevitably limited. Though training can allow them to cope with some complications, it will not remove the need for hospital-based interventions. Given the challenges associated with creating an effective referral link between TBAs and hospitals, some have suggested that TBA training programs are inadequate responses to high maternal mortality. If TBAs cannot or will not refer women to obstetric care facilities in time to save their lives, are we better off focusing our attention on increasing institutional births rather than promoting traditional birth assistants?

While the referral link between traditional birth assistants and hospitals has been historically weak, there are good reasons to believe that this could change. A wave of technological innovations in the field of maternal health has brought two groups of technologies that seem particularly applicable to the issue of strengthening the connection between TBAs and hospitals.

The first of these groups of technologies include innovations that may widen the time window during which life-saving referrals can be made. This group of technologies included anti-shock garments (see the LifeWrap and my earlier post) which respond to inevitable transportation delays by providing a means to stabilize a woman long enough to be transported to the hospital. Elsewhere in the medical technology world, new low-cost home tests for pre-eclampsia are emerging (see Jhpiego), offering the possibility of earlier detection of obstetric emergencies. Technologies such as these could play a vital role in improving the effectiveness of TBA training programs by increasing the number of cases in which referrals can be made in time to save the mother.

In addition to technologies that improve referral outcomes, other technologies respond to the need to increase the rates of timely referrals. A 2004 survey identified the development of clear referral guidelines as an important component of successful maternal referral programs.[iii] Historically, the principal tool for this purpose has been the partogram. Partograms, which track the progress of labor by plotting indicators such as cervical dilation, fetal heart rate, and duration of labor, assist doctors in identifying when pharmaceutical or surgical intervention is necessary. While highly cost-effective, partograms have proven inappropriate in many settings, particularly ones in which birth assistants are relatively less educated. The relative complexity of the partogram has prevented it from being widely used among traditional birth assistants. In response to this issue, a new version of the partogram has been developed which provides a simpler set of referral guidelines. Called “the paperless partogram,” this system requires birth assistants to perform two simple calculations in order to calculate an ALERT estimated delivery time and an ACTION estimated delivery time. Birth attendants are instructed to make arrangements for transportation to a facility with surgical capabilities at the ALERT time and to deliver the baby at the ACTION time. [iv] This system, combined with other tools such as mobile phones which play an increasingly important role helping TBAs to determine an appropriate course of action, may result in a more effective maternal referral program.

Technologies, however well designed, ultimately are only tools. Developing the link between traditional birth assistants and hospitals will require further education efforts and thoughtful adaptation of technologies to meet local needs. Still, the emergence of tools such as the LifeWrap and the paperless partogram should prompt us to reconsider premature eulogies on traditional birth assistant training programs. Many barriers to effective maternal referral systems continue to exist, but we have yet to exhaust the possibilities for making them work.

[i] Sogunro, Oluremi. “Traditional obstetrics; a Nigerian experience of a traditional birth attendant training program.” International Journal of Gynecology & Obstetrics. Volume 25, Issue 5, October 1987, Pages 375-379

[ii] Sibley et al. “Cultural Theories of Postpartum Bleeding in Matlab, Bangladesh: Implications for Community Health Intervention.” Journal of Health, Population and Nutrition. June 2009. pp 379-390 <<http://centre.icddrb.org/images/JHPN273-Cultural_Theories_of_Postpartum_Bleeding_in_Matlab,_Bangladesh.pdf>

[iii] “Tsu, V.D. and B Shane. “New and underutilized technologies to reduce maternal mortality: call to action from a Bellagio workshop.” International Journal of Gynecology & Obstetrics
Volume 85, Supplement 1, June 2004, Pages S83-S93. <<http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T7M-4CDRKC3-B&_user=145269&_coverDate=06/30/2004&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1645749489&_rerunOrigin=scholar.google&_acct=C000012078&_version=1&_urlVersion=0&_userid=145269&md5=0a29a3a723d862bb77421ef2c20fa6ef&searchtype=a#toc37>>

[iv] “The Paperless Partogram: A simplified tool to prevent prolonged labor.” Maternova. <<http://maternova.net/blog/paperless-partogram-simplified-tool-prevent-prolonged-labor>>

iv. The Life Wrap. <<http://www.lifewraps.org>>.

v. “Jhpiego among first recipients of innovation award from USAID.” 11 October 2010.  <<http://www.jhpiego.org/media/releases/nr20101012.htm>>.

Andhra Purdesh and a Crisis in Microfinance

February 16th, 2011

In October 2010, Andrha Purdesh, one of the largest states in India, enacted a law that had sweeping ramifications for microfinance as a sector. Owing partially to a spate of some 75 suicides related to individuals unable to repay loans to MFI’s (Micro-Financial Institutions) (http://headlinesindia.mapsofindia.com/state-news/andhra-pradesh/microfinance-firms-fear-andhra-pradesh-law-will-hurt-them-70584.html), the state has legislated a series of hurdles designed to reduce the ability of microfinance organizations to take advantage of the state’s poorest citizens. Some of these policies include requiring MFI’s to register with the state and obtain specific permission when loaning to citizens with other outstanding debts, banning MFI’s from manually collecting debts on a weekly basis, and preventing MFI’s from accessing bank loans themselves or making new loans to borrowers. As a consequence of these laws, repayment rates have plummeted in the region from 90% to 10-15% (http://www.livemint.com/2011/02/14222236/AP-insists-it-won8217t-repe.html?atype=tp).

This series of laws has had wider ripples in the MF industry, adding a political component of risk to an already risky practice. With such instability, potential loaners willing to accept lower rates of return in exchange for potentially helping to alleviate poverty might be less willing to invest. Further, Andhra Purdesh is likely to suffer a poor reputation with MFI’s, leaving the state’s poor with no option but dealing with traditional moneylenders, who can charge rates exceeding 80% (http://www.guardian.co.uk/global-development/poverty-matters/2011/jan/26/microfinance-regulations-india).

But some good has definitely emerged from the standoff. In response to MFI concern over the Andhra Purdesh laws, as well as growing political pressure to better regulate the industry, the Reserve Bank of India has asserted its authority over the industry, and it has issued a series of rules for priority-status MFI’s that are designed to protect the rights of both the consumer. Among these (quoted from http://www.microfinancefocus.com/content/rbi-releases-malegam-committee-report-microfinance):

a. The NBFC-MFI will hold not less than 90% of its total assets (other than cash and bank balances and money market instruments) in the form of qualifying assets.

b. There are limits of an annual family income of Rs.50,000 and an individual ceiling on loans to a  single borrower of Rs.25,000

c. Not less than 75% of the loans given by the MFI should be for income-generating purposes.

d. There is a restriction on the other services to be provided by the MFI which has to be in accordance with the type of service and the maximum percentage of total income as may be prescribed.

Additional recommendations include preventing more than two MFI’s from loaning to any one consumer, and there must be a minimum period of time between issuing the loan and recovering it. Already, prominent MFI’s are heralding the RBI’s new laws for regulating an industry badly in need of reform, but Andhra Purdesh has yet to put aside its own rules in favor of the RBI’s. Because in Andhra Purdesh the RBI’s policies are seen as less stringent, and because popular sentiment still runs so counter to microfinance, it is unlikely politicians there can safely reverse policy anytime soon. This could spell the end of microfinance in a region that could stand most to benefit from a well-regulated industry (http://economictimes.indiatimes.com/markets/stocks/stocks-in-news/malegam-committee-report-sks-stock-up-13/articleshow/7325232.cms).

A Solution to the Seemingly Unsolvable?

February 10th, 2011

The underlying issues that surround water access in sub-Saharan African sometimes seem insurmountable.  A lack of clean water only cements existing gender inequalities, and implementing an effective solution to the problem is much easier said than done.  In the fight for gender equity and water access, it’s easy to burn-out, become frustrated, lose hope.

After six blog posts documenting the numerous challenges to addressing gender inequalities alongside lack of clean water, I chose to focus this entry on something more uplifting: a solution.  Although implementing effective programs is daunting and fraught with room for error, there are organizations doing amazing work on the ground to combat these problems.  They often succeed.  This blog entry will focus on a particular organization that, I believe, could serve as a model to providing sustainable water access that best serves women.

The Global Women’s Water Initiative — a joint venture of Women’s Earth Alliance, Crabgrass, and A Single Drop — operates in West and East Africa.  It’s community-based approach empowers local women with the technological, entrepreneurial, networking, and financial support they need in order to fund their own sustainable water access programs.  The GWWI is well aware of the pitfalls that have befallen past programs t: too often, organizations implement programs without the input of the community itself, specifically women.  The result is a failed initiative  that fails to address the root of the problem (1).  In contrast, the GWWI sees local women as the primary instigators of  change, harnessing their knowledge and expertise in order for them to design their own community-specific solutions to water access.

The Women’s Earth Alliance, which overseas the GWWI , operates its programs on a series of simple, yet effective principles.  As mentioned previously, WEA functions on a bottom-up approach that employs the skill set of local women themselves.  In this way, programs don’t run the risk of cultural ignorance or insensitivity that could block effective solutions.  Secondly, WEA relies on local and cheap technology to implement their programs.  Examples include reused cardboard box solar cookers, rainwater harvesting from rooftops, and water filtration systems using rocks and sand.  Next, WEA ensures that every individual woman leader is not alone in her efforts.  Women work in pairs, and each pair and accompanying team is matched with a “Global Peer,” or a female leader in an international country.  All participants in WEA programs can review each others water programs and make suggestions for improvement online.  Finally, and in my opinion most importantly, WEA relies on what they can an “Each one, teach one” approach.  Each woman trained creates a ripple effect by teaching other women the same invaluable information.  In this way, WEA participants pay it forward, with strong female community leaders inspiring others to take up the gauntlet and start their own projects (2).

The WEA Africa Program, or GWWI, has roots in 13 different African countries and 30 different community-organizations (3).

GWWI offers two main kinds of training programs for women: the Grassroots Women Leaders Training Program and the Masters Trainer’s Training Program.  The latter essentially builds on the former and teach the same subjects in slightly greater depth (4).  Both training programs operate on the same basic framework split into three components: Design, Training, and Implementation.

The training phase consists of a week-long curriculum that focuses on the issues relating to water access that are most pressing for the women participants’ communities.  For example, the pilot program based in Nairobi, Kenya taught each pair of women skills in solar cooking, water sanitation hygiene (WASH strategies), rainwater harvesting, business planning, proposal writing, and water testing (5).

After this weeklong design phase, women attend a 7 day hands-on training to learn about sustainable and effective water technologies from skilled African women who specialize in those topics.  At the end of the week, each female pair design their own community-specific program and obtain a microloan to launch this project.

After the Training Phrase ends, GWWI continues supporting its teams of local women through a variety of different measures: GWWI follows the progress of its women leaders by performing frequent on-site visits, giving additional money as needed, and facilitating communication between Global Peers and and female community leaders (6) .  In addition, GWWI gives every woman a flip camera with which to document her progress and write about it in an online forum (7).

The pilot GWWI program was launched in 2008 in Kenya.  The thirty women selected for the program out of a large pool of applicants displayed huge diversity: they ranged in age from 25-72 and spoke between 4-8 languages.  Many were already local leaders, running their own farms, organizing local women’s cooperatives, and campaigning for issues like land rights, HIV/AIDS prevention,environmental protection and political corruption (8).

In 2010, the GWWI followed up its 2008 model with a West African program based on 15 teams from Togo, Ghana, Nigeria, Liberia, Cameroon, and Mali.

The video below documents highlights from the 2010 West African Women & Water Training.  To see hundreds of women coming together from all around the region to combat the issue of clean water access is truly inspirational and powerful.  All of the articles I have read thus far point to the importance of including women’s voices in providing sustainable water access.  Yet this integral step is also one of the hardest to put into effect.  So far, this is the first organization I have come across that recognizes the true importance of the woman’s voice and does everything in its power to ensure that gender equity is in place before attempting to combat issues of water access.  I am sure that its leaders will accomplish great things going forward.

Women\’s Conference on Water 2010

Works Cited:

1) http://www.womensearthalliance.org/section.php?id=116

2) http://www.womensearthalliance.org/section.php?id=65

3) http://www.womensearthalliance.org/section.php?id=149

4) http://africanwomenandwater.org/description/

5) http://www.womensearthalliance.org/article.php?id=377

6) http://africanwomenandwater.org/description/

7) http://www.womensearthalliance.org/section.php?id=65
8) http://www.womensearthalliance.org/article.php?id=377

Interview with Matt Bannick, Managing Partner at the Omidyar Network (Part Two)

February 10th, 2011

Last week, I posted the first half of my conversation with Matt Bannick, Managing Partner for the Omidyar Network, which so far has invested over $330 million in both for-profit and non-profit organizations designed to help elicit positive social change. In the first part, I focused particularly on what he called “flexible capital,” wherein the Omidyar Network can invest in nonprofit or for-profit organizations, primarily on the basis of which strategy is likely to have the most successful outcome.

This week, I want to focus on some of the organizations Mr. Bannick and the ON have been excited to give grants to, namely D.Light, a project out of Stanford, and the Bridge Academy International schools set up in Nairobi. Said Mr. Bannick:

D.Light is a solar lantern company. The problem they’re trying to address is that in many parts of Africa and India, people in the rural areas have no light in the evenings. And what they use typically is kerosene. And the problem with kerosense is that it creates noxious fumes, so it’s a health hazard. It’s also expensive and it obviously has a pretty high carbon footprint. D.Light has developed a solar lantern that’s down to eight dollars. And the solar lantern, you charge it for six hours and it gives you six hours of light. So all of a sudden, you don’t have to buy kerosene, you’re healthier, and you can read and get a better education, and it can transform the life of a household. So that’s one company that we’ve invested in, and I think they’ve now sold more than a million units worldwide.

There’s another example in Nairobi in a chain of schools called Bridge Academy International, and what they’ve been able to do is to get the cost of creating a fabulous education (and by the way, as background, in Kenya, everyone is entitled to schooling, but in reality the teachers don’t show up. And to show up frequently they expect bribes, and so the system fundamentally doesn’t function. And so Bridge Academy has come in, they’ve developed a very low-cost model where they can provide a fabulous education to children in the slums of Nairobi for $4 a month. It’s truly exceptional. They’re now bringing even on their first schools and their hope and their desire is to build out thousands of schools across Africa that could deliver very high-quality education at very low cost to the poor.

I do wonder a bit about the discrepancy between the eight dollar cost to manufacture the solar lamps and the thirty dollar pricetag mentioned on the D.Light website for an American to buy a light and give it to an impoverished person in East Timor, but profit or not, it’s clear that solar-powered lights can be incredibly helpful. And maybe, as Mr. Bannick explained in Part One, using for-profit organizations can effect quicker change, as having a margin of profit can add more fuel to growth and allow for the quicker spread of disruptive technology. In impoverished nations, there does continue to be the spectre of abuse that can occur when labor is cheap and desperate, but when money is given to people concerned with doing good first, then making profit (more as a means of sustaining growth than an end in itself) second, it can still have massive positive impact.

Read the full interview below for more on what kinds of entrepreneurs the Omidyar Network tends to invest in, for the breakdown of international vs. local and male vs. female entrepreneurs, and for his analysis of the nonpayment movement. And immediately below are some of the organizations he mentions.

  • D.Light: low-cost, Stanford-based solar-powered light manufacturer.
  • Bridge International Academies: Low-cost, high-quality education for underprivileged African children.
  • Endeavor Global: An organization fostering high-impact entrepreneurship.
  • Omidyar Network: A philanthropic organization that gives to both nonprofit and socially conscious for-profit organizations.


KW: What’s an organization that you’ve invested in that has been for-profit that you’ve been most excited about?

MB: Well, since you’re at Stanford now, I’ll use a Stanford example. Have you heard of the “Design for Extreme Affordability” program at Stanford?

KW: I actually have, yeah.

MB: Have you heard of D. Light?

KW: The name sounds familiar.

MB: So D.Light is a solar lantern company. The problem they’re trying to address is that in many parts of Africa and India, people in the rural areas have no light in the evenings. And what they use typically is kerosene. And the problem with kerosense is that it creates noxious fumes, so it’s a health hazard. It’s also expensive and it obviously has a pretty high carbon footprint. D.Light has developed a solar lantern that’s down to eight dollars. And the solar lantern, you charge it for six hours and it gives you six hours of light. So all of a sudden, you don’t have to buy kerosene, you’re healthier, and you can read and get a better education, and it can transform the life of a household. So that’s one company that we’ve invested in, and I think they’ve now sold more than a million units worldwide.

There’s another example in Nairobi in a chain of schools called Bridge Academy International, and what they’ve been able to do is to get the cost of creating a fabulous education (and by the way, as background, in Kenya, everyone is entitled to schooling, but in reality the teachers don’t show up. And to show up frequently they expect bribes, and so the system fundamentally doesn’t function. And so Bridge Academy has come in, they’ve developed a very low-cost model where they can provide a fabulous education to children in the slums of Nairobi for $4 a month. It’s truly exceptional. They’re now bringing even on their first schools and their hope and their desire is to build out thousands of schools across Africa that could deliver very high-quality education at very low cost to the poor.

KW: OK. Now, this class is for International Women’s Health, so I have to ask this question, which is, what’s the breakdown been of entrepreneurs who have been male versus female?

MB: Oh gosh. I think it varies. I’d have to go through. I mean, there have been terrific entrepreneurs, both male and female. Many of our organizations we support do have a gender focus on women. So for example there’s an organization in Seattle called Landessa that works on rural property rights, and they have a whole area that focuses on women and land, women and property rights. The schools in Nairobi, one of the exciting things about them is that about fifty percent of the kids attending those schools are girls, and that may not sound remarkable until you realize that in most places, when school becomes expensive, the families send boys first, and then if they have money left over they send girls. So one of the positive impacts here is that you’re able to actually to get the cost down to a point to where the girls can go to school. And there are implications of educating girls—they tend to marry later, and they tend ot have fewer children. And their children tend to be healthier and better educated. So there’s huge returns, and you probably studied this in the women’s health class, there are huge returns on educating girls. So we have a bit of a bias toward those organizations, those companies that disproportionately benefit women and girls.

KW: Backing up and talking a little bit more about the entrepreneurs that you tend to invest in, what do you use to identifiy which entrepreneurs are going to succeed? Do you have any sort of bias toward people who are working in their own countries, or people who are going to other countries?

MB: Yeah, you really want people with local knowledge, and sometimes, like in the case of Bridge Academy, they’re Americans but they’ve been in Nairobi for some time, and they have been successful entrepreneurs. [We look at] the caliber of the entrepreneur, their reputation, their track record, their knowledge of the market, they’re looking to serve, then you look at the quality of the idea, the market size, the competitive environment. You know, many of the same things that you would tick through when you’re looking at an investment for [a company] would be the exact same criteria that we’d be looking at as well.

Now the added dimension for us is that we’re looking for investments that will create opportunity for hundreds of thousands. Whereas the objective at [an investment firm] would be, OK, well what is the return on investment?, we absolutely would look at return on investment, but we also look at social impact and we’d be willing to have a little lower return on investment in exchange for a higher social impact.

KW: That’s awesome. I did want to ask whether the non-payment movement that’s been affecting a few different countries has been affecting you guys at all.

MB: So we’re not directly invested in MFI’s [Micro-Finance Institutions] in [any of the affected regions], but we are invested in funds that are invested in MFI’s in India, so yeah, I think the whole sector has been affected by the challenges in [that region], and unfortunately I think that microfinance institutions should have done a better job in the areas of consumer protection and in the area of establishing effective credit bureaus to guard against over indebtedness. I also hope that people recognize that microfinance is delivering tremendous value to the poor, and we need to figure out how to strengthen the industry, rather than do things that inhibit people who don’t have the means from receiving credit.

KW: The final question that I have is how do you think you can foster a more entrepreneurial spirit in the third world, and as a follow-up, do you think that it should be encouraged.

MB: Well absolutely. I think that entrepreneurship is key to ideas, to job creation, to economic development, and I think people inherently want to make a better life for themselves and their families. Entrepreneurship, in addition to helping societies progress economically, also gives people hope, and also taps their creative spirit, and I think it’s absolutely essential that societies support entrepreneurship. One of the organizations that you might take a look at is a group called Endeavor Global, and I’m on the board there. Endeavor is very much focused on fostering entrepreneurship in the developing world, and they have a lot of good facts and figures on their website that you can check out. But I think that it’s absolutely critical.

KW: Thank you so much, I really appreciate the time that you took for this, and I hope that you’re getting as much satisfaction out of the work that you’re doing as you should be.

MB: It’s fabulous, and who I am, and the work I do, and the values I want to pass onto the kids are all the same thing, which makes it very gratifying.

Hospitals reduce maternal mortality, right?

February 10th, 2011

In an earlier post I suggested that, in order to have the best chance at surviving childbirth, a woman must have access to a trained medical professional. It seems reasonable to believe that women may have the best chance at survival if they gave birth at a hospital – after all, hospitals offer access to surgical facilities, drugs, and highly trained medical professionals. But, if the advantages of hospitals come with long delays and overburdened staff, can hospitals really offer high quality obstetric care?

While rotating through hospitals in Oaxaca, Mexico last summer, I found the OBGYN wing where I worked to be one of the most striking examples of the consequences of an overburden healthcare system. Hospital in Civil in Oaxaca has one of the highest rates of delivery by caesarian section in the country. At nearly 50%, the rate is roughly four times the rate recommended by the World Health Organization.[1] While working in this OBGYN wing, I asked one of the more candid anesthesiologists why the hospital preformed so many caesarean sections. After repeating back to me the usual patter about the hospital seeing a high proportion of complicated pregnancies, he told me: “look, this hospital has more surgical interns than it knows what to do with. They need the practice.”

All else being equal, the probability of significant complications post-delivery are much higher for c-sections than for vaginal deliveries. As with any major surgery, c-sections have a significant risk of post-operative infection. This is particularly true in the developing world where maintaining a sterile environment is more challenging due to cost and time constraints. Except in cases of medical necessity, vaginal delivery is significantly preferable to c-section from the perspective of the health of the mother.

A recent study on the overuse of caesarian sections in Mexico uncovered a complex set of causes for the elevated rates of c-section in Mexico. Importantly, a significant source of unnecessary c-section arose directly from insufficient medical knowledge regarding when c-sections were necessary. A study by Leslie Farland found that roughly 15% of c-sections in Mexico are preformed because the woman had a previous c-section, despite the fact medical research has shown this to be unnecessary.[2]

Digging a little more into the broader environment in which unnecessary c-sections occur, I found that the overuse of c-sections is not an isolated weakness in the medical system. Studies into other maternal care issues in developing world hospital have found that factors such as the failure to respond quickly to emergency situations, a lack of availability of needed drugs, and insufficient surgical skills contributes significantly to the maternal mortality rate.[3] A study at a hospital in The Gambia found that 34% of the maternal deaths in the hospital could be linked to a failure of the hospital staff to properly manage their case. [4] These cases represented women who got to the hospital in a timely manner, well before they were beyond saving.

Staff and resource limitations in hospitals pose a serious threat to maternal survival. In Oaxaca, there is only 1 hospital bed for every 1,000 individuals.[5] In this environment, developing a well-functioning triage system is difficult even if you have sufficient numbers of doctors, which of course, many hospitals do not. Under resourced hospitals cannot be expected to provide highly-effective emergency obstetric care.  If the hospital system fails to fulfill this role, a critical tool for combating maternal mortality is lost. Training skilled birth attendant who can make timely referrals to hospitals is a critical component of the push to decrease maternal mortality statistics. But, in order for this program to work, we also need to focus on strengthening the hospital system so that it can more effectively respond to these referrals.

[1] Farland, Leslie. “The Use and Overuse of Caesarian Sections in Mexico.” University of Chicago. August 2009. <<http://www.mujeresenlazadas.org/index_files/Cesarean%20Sections%20in%20Mexico.pdf>>.

[2] Ibid

[3] Hoestermann et al. “Maternal mortality in the main referall hospital in The Gambia, West Africa.” Tropical Medicine and International Health.Vol 1. No 5. October 1996. Pp 710-717.

[5] Loewengberg, Samuel. “The plight of Mexico’s indigenous women.” The Lancet. Vol 375. Issue 9727. May 2010. Pp. 1680-1682.

Women’s Rights Implications in Post-conflict Afghanistan

February 9th, 2011

After 9/11, the Bush administration authorized the use of force in Afghanistan, an operation given the name Enduring Freedom. Ten years later, the U.S. is still heavily involved both militarily and from a civilian operation capacity as it and its NATO allies fight to create stable security forces and a government. Originally, it was understood that fighting al-Qaeda necessitated the removal of the Taliban regime, which had become symbiotically intertwined with the fundamentalist terrorists. Taking away the patron government for al-Qaeda was the central reason for the use of force, however many officials and scholars point out that the Taliban’s defeat would result in a net gain for women’s rights in the country. Before the Taliban came to power, women were 70% of the school teachers, 50% of the government workforce, and 50% of the students at the main university in Kabul.[1] In fact, Afghanistan had a relatively egalitarian society in comparison to many of its neighboring countries.

This all changed once the Taliban took power. After 1996, the fundamentalist regime effectively shuttered women in the homes. They were prohibited from working or going to school and could not leave the house at all unless accompanied by a “close male relative.”[2] Those women who had suffered the loss of their male relatives during the Soviet War essentially became imprisoned in their own homes. Women could be wantonly accused of prostitution or infidelity, crimes that came with a public death sentence by stoning or hanging. Once the U.S. and NATO forces arrived and deposed the Taliban, women finally received the political attention they deserved. The new constitutions adopted in 2004 reversed many of the policies that the Taliban had instituted. Bearing in mind several UNSCR resolutions that support female political empowerment, the new constitution guaranteed gender equality as an important ideal, gave women the right to vote, and reserved 25% of the seats in the lower house of parliament for women leaders.[3][4] Afghanistan now has one of the highest levels of mandatory female political leadership in the world. These are significant legal gains for women, but it does not directly address many of the cultural problems in which the Taliban’s policies were rooted.

As Hamid Karzai continues to struggle with managing the new government while facing a vigorous insurgency, it is rapidly becoming apparent that a reintegration of the Taliban as political stakeholders will be necessary. This is an unfortunate reality for many post-conflict regimes; effectively, the deposed powers must find a political solution to their struggle if they are to have an incentive to put down their arms. NATO leaders have publicized a new policy that allows Taliban fighters to surrender, undergo vocational training and become part of the new political and security apparatus.[5] This policy is outlined in hopes that it will dissuade Afghans from joining the insurgency and instead focus on rebuilding Afghanistan. For now, these “rehabilitated” soldiers are behaving, but there is a significant risk that once the military forces pull out, they will use their new political power to roll back many of the gains that women have won.

The U.S. has a responsibility to maintain a strong relationship with the Karzai government to ensure this doesn’t happen. As its largest patron, it has significant leverage for directing the policies that the government produces. Using these levers of influence will be key to ensuring women are not again disenfranchised. Aid for Afghan women to start businesses and support their families would also encourage long-term female empowerment. Finally, if women in certain regions are again subjected to harsh restrictions, the U.S. and its allies should relax their asylum policies to allow those women the opportunity to come to the West to find refuge. If these policies are pursued, there will be a good chance that women will hold on to the rights they have gained and continue to push for better education, health, and access to employment.

[1] Hanford, Cindy. “Women’s Lives Under the Taliban.” National Organization for Women. www.now.org. November 2001.

[2] Hanford.

[3] “Resolution 1889.” United Nations Security Council. United Nations. Oct. 5, 2009.

[4] Cortright, Peter and Sarah Smiles Persinger. Afghan Women Speak: Enhancing Security and Human Rights in Afghanistan. Kroc Institute for International Peace Studies, University of Notre Dame. www.nd.edu. October 2010.

[5] “Afghan Taliban starting to reintegrate?” United Press International. www.upi.com. Jan. 5, 2011.

Counterterrorism through female reproductive and education empowerment

February 3rd, 2011

Throughout the Middle East, there is a demographic phenomenon that has been linked to an increased likelihood for terrorist activities, and it is commonly known as the “youth bulge.” A “youth bulge” is usually defined as a “high proportion of 15-to-29 year olds relative to the adult population.”[1] When a country has this overpopulation of young people, it has a statistically higher chance for civil conflict, terrorism, and widespread violence throughout society. The causes of this violence are attributed to the difficulty of the economic system to provide meaningful economic opportunity to occupy the population. The youth become disaffected and resentful of the population with means, especially when the educated population cannot find gainful employment. Currently, there are 67 countries with these “youth bulges” and 60 of them are experiencing a civil war or mass killing.[2] Because of its enormous young population and propensity for this sort of behavior, the Middle East is often identified as a classic example of this problem.

This problem is exacerbated for women when the gender ratio is decidedly unbalanced. It becomes even more difficult for women to find political and economic opportunity when men vastly outnumber them in vying for these positions, especially in societies that have distinctly patriarchal tendencies, such as the Middle East. In fact, the Middle East has 8 out of the top 10 most gender-unbalanced countries in the world.[3] Additionally, the Middle East has one of the most numerous youth populations in the world, where between 50-60% of the population in the region is under 24.[4] Therefore, with a young, mostly male population, the region has set the demographic conditions that combined with lack of economic opportunity and repressive politics often lead to terrorism and other forms of violence.

There are several ways that impacting women’s rights can have a positive effect on these statistics. First, there needs to be increased access to contraceptive and abortion options for women. Nine countries in the region have an average of 3-5 births per woman and another nine have an average of over 5 births per woman.[5] This high fertility rate fuels the youth bulge and worsens the chance that those children will have an economic system that can incorporate them effectively. With greater access to family planning methods, women in the Middle East can begin to focus on an appropriate family size and pinch off the bulge before it gets worse. This process is known as demographic transition, where society shifts from a population “typified by short lives and large families to one with long lives and small families.” Another method for countering the bulge is through improved access to female education. It has been shown elsewhere that women’s access to higher levels of education will delay the time a woman gives birth to her first child and increase the chances she has a smaller family. Both of these methods would serve to decrease the youth bulge and begin the process of demographic transition.

With terrorism arguably the number one security threat facing most Western societies, it is time that policy makers begin to address the fundamental causes of the problem. Military intervention has its purpose, but it often does not fix the underlying problems in a society that produces terrorism. By looking to alternative means, to be used in conjunction with military options, policy makers can not only increase the security of the international system but improve the lives of a significant population that resides within it.

[1] Cincotta, Richard. “State of the World 2005 Global Security Brief #2: Youth Bulge, Underemployment Raise Risks of Civil Conflict.” www.worldwatch.org. March 1, 2005.

[2] “Are Youth Bulges the Root Cause of Terrorism?” lawandotherthings.blogspot.com. Jan. 27, 2008.

[3] Archbold, Peter. “The imbalance of the male to female ratio.” www.socyberty.com. Oct. 19, 2006.

[4] Fuller, Graham E. The Youth Factor: The New Demographics of the Middle East and the Implications for U.S. Policy. www.brookings.edu. Jan. 18, 2003. pp 3.

[5] Fuller pp 7-8

Interview with Matt Bannick, Managing Partner at the Omidyar Network (Part One)

February 3rd, 2011

Matt BannickThis afternoon I had the distinct pleasure of interviewing Matt Bannick, current Managing Partner at the Omidyar Network and former President of PayPal and eBay International, as well as formerly serving as a diplomat to Germany. The conversation ran long (there’s plenty to talk about in microfinance!), so I’ll post some highlights here at the top, and the full transcript of the first half of our conversation below for anyone interested.

The Omidyar Network, for those who are new to this thread, is a philanthropic organization begun by eBay founder Pierre Omidyar that uses a combination of grants and investments to try to effect the most positive change globally that it can. Said Mr. Bannick:

One of the things that distinguishes us is an approach that we call “flexible capital.” Most philanthropic organizations are set up just to do grants, and we do grants and we do investments. And by flexible capital we look at what the problem is first, and who’s addressing that problem, we focus on the entrepreneur that’s trying to address that problem, and then and only then do we determine what’s the most effective type of capital to deploy…

We’ve actually done 14 not-for-profit deals and 12 for-profit deals. And in total we’ve probably invested more than $100 million. So we see the two kinds of investments as complementary—you may do a not-for-profit investment to help develop infrastructure for a sector, and then you’d do a for-profit investment in a company in that sector that can really drive scale. One of the problems with not-for-profits is that they find it really difficult to scale. For example, in the US in the last 40 years, there have only been 150 not-for-profits that have scaled to $50 million in revenue or more. In that same period, there have been thousands and thousands of for-profit companies that have scaled to $50 million in revenue or more.

This model feels unique and exciting, and I’m interested in where it goes. As any money they make is subsequently funneled into future philanthropy, the potential impact of the Omidyar Network is enormous. Next week, I’ll include the second half of the interview, where we talked about some of the specific organizations Mr. Bannick was particularly excited about.



KW: What drove you to switch to being interested in philanthropy versus the private sector?

MB: I’ve long had an interest in having a positive impact in society. I started out early in my career, I was actually an American diplomat. I was in Germany when the wall came down. I found that deeply rewarding work. And the issue of that age was the Cold War and the battle between a system that created opportunity for individuals and celebrated potential and freedom of the individual and a Communist system that oppressed the individual. And so I did feel at that stage that I was actually engaged in working on an issue of the greatest import.

I went to business because I loved the action orientation of business. In diplomacy there was a lot of talk on really important issues, but as a young diplomat you couldn’t have an immediate impact on issues of great import. I went into business and initially into business school and consulting because I liked what I perceived to be the action orientation of business, and I had been in banking before I’d gone into diplomatic service, and in my career I was really fortunate most particularly at eBay to both be working to build a fabulous business, but also a business that delivered positive social impact. For me it also had an international dimension. I ran eBay International and I ran PayPal, and PayPal is now building their international footprint as well. I was able to do the things I really liked to do in terms of running a successful business. I really liked the leadership component of that and I also was able to do the international piece and feel like we were creating opportunity for individuals at eBay, we were creating social impact.

All of that said, the thing that led me to philanthropy was really a desire that the bottom line for me, the objective of my work to be positive social impact, rather than at eBay where we were having positive social impact but the bottom line ultimately was about dollars and cents. So meeting with Pierre and learning about the Omidyar Network, the real draw for me was saying, “Look. I can use the skills I learned in business,” because Pierre had a very expansive view of having impact, which included business, I can use the skills I learned in business in an environment where the bottom line was social impact, and that was very, very compelling to me. I do think as I go back to my reflections of the Cold War and that being the issue of our age, I think the issue of our age in our contemporary global society is that you have billions of people around the world who lack opportunity, and who inherently capable.

One of our lessons at eBay was that people are inherently good, inherently capable, and we created a tech platform where they could use tap their skills and do fabulous things. And what’s lacking in the world today is opportunity for billions of people to realize that potential. And where ON is centered on supporting entrepreneurs who create opportunity for millions. So that’s how it’s come arund for me and in a sense it’s new, but in a sense it’s back to where I was grounded back when I was a diplomat in Germany.

KW: That’s very cool. How would you describe your role in the Omidyar Network?

MB: I am the managing partner here, so I am responsible for finding and executing against Pierre’s vision on how to have massive positive social impact. That would be my high-level job description. I’m responsible for the results of the entire organization.

KW: How many people are in the organization?

MB: We have probably now about 44, 45. We have one in London, 8 in India, and the rest here in Redwood City.

KW: One of the things that made the Omidyar Network stand out to me is that most microfinance organizations invest in people who will be employing one person, which is themselves. What led the Omidyar Network to start investing in bigger sized organizations? Because that’s really what differentiates it from a lot of the things I’ve seen, looking at microfinance.

MB: Microfinance is one of six investment areas. One of the things that distinguishes us is an approach that we call “flexible capital.” Most philanthropic organizations are set up just to do grants, and we do grants and we do investments. And by flexible capital we look at what the problem is first, and who’s addressing that problem, we focus on the entrepreneur that’s trying to address that problem, and then and only then do we determine what’s the most effective type of capital to deploy. So that’s really what defines us in many ways, is focus on the entrepreneur, focus on the ability of the entrepreneur to scale, and then figuring out what the right type of capital is to deploy.

Most philanthropists focus on grants of about $100,000 to $200,000; our average deal size is in the $2-4 million range, so in that sense we focus on bigger ticket deals, and so I think this for profit and not-for-profit model is more distinguishing.. Within the realm of microfinance, we see them—for-profit and not-for-profit—as very complementary, and in the realm of microfinance, we’ve actually done 14 not-for-profit deals and 12 for-profit deals. And in total we’ve probably invested more than $100 million. So we see the two kinds of investments as complementary—you may do a not-for-profit investment to help develop infrastructure for a sector, and then you’d do a for-profit investment in a company in that sector that can really drive scale. One of the problems with not-for-profits is that they find it really difficult to scale. For example, in the US in the last 40 years, there have only been 150 not-for-profits that have scaled to $50 million in revenue or more. In that same period, there have been thousands and thousands of for-profit companies that have scaled to $50 million in revenue or more.

So for for-profit, it’s not about making money, because whatever money we make on our for-profit investments goes back into our philanthropy, but the point is that for-profit businesses are all about getting big. And because they’re generating revenue, that provides them with the ability to have a bigger scale impact.