http://www.ssireview.org/articles/ Strategies, Tools, and Ideas for Nonprofits, Foundations, and Socially Responsible Businesses en walker_kelsey@gsb.stanford.edu Copyright 2008 2008-09-02T19:00:01-08:00 http://www.ssireview.org/articles/entry/whats_next_livinggoods_calling/ http://www.ssireview.org/articles/entry/whats_next_livinggoods_calling/ Chuck Slaughter, founder of clothing company TravelSmith, has a secret he doesn’t often share: He’s an Avon lady. But he only enlisted to better research the cosmetics giant, he explains, having had a “eureka” moment. If children in developing countries are dying because their parents can’t find or afford the requisite drugs, then why not deliver low-priced drugs to their doorsteps using an Avon-style direct sales technique? In 2004 Slaughter had been hired to turn around the struggling Child and Family Wellness Shops—microfinanced franchises in Kenya that distribute affordable medical products and services to remote communities—and he only succeeded, he says, once he had “gotten the clerks off their tails” and into schools and churches to sell their wares. “And later I thought maybe we don’t need the store at all. Maybe it’s not McDonald’s we want to imitate, but Avon.” (See “Micro-Franchise Against Malaria,” Stanford Social Innovation Review, fall 2007.) Slaughter now helms LivingGoods, a nonprofit he founded last year that sends its version of Avon ladies—white-uniformed “health promoters”—knocking on neighbors’ doors in 200 Ugandan communities. (That number will rise to 680 over the next few months.) From fat shoulder bags they sell… Health Care, Social Entrepreneurship 2008-11-16T06:00:00-08:00 http://www.ssireview.org/articles/entry/opening_the_asylum_doors/ http://www.ssireview.org/articles/entry/opening_the_asylum_doors/ Social reforms that occur too quickly or promise radical change often fail. Retrenchment and blaming of the reforms’ beneficiaries typically follow. Indeed, prolific author and psychiatrist E. Fuller Torrey outlines in his new book, The Insanity Offense, two quixotic reforms of the 1960s and 1970s that followed just this pattern: the adoption of cost-cutting deinstitutionalization policies that whittled down American public mental hospital patients from more than 550,000 in 1955 to fewer than 40,000 at present (despite the nation’s population having doubled); and the extension of civil rights to those with mental illness that make it nearly impossible to commit someone to a mental facility involuntarily. (A half century ago, all it took to commit a patient was a psychiatric recommendation and a judicial order.) These reforms, which emanated from a curious combination of conservative, libertarian, and liberal forces, have allowed people who are sometimes dangerous and who often lack insight into their deteriorated mental states to languish in decrepit community facilities or even on city streets, without any means of getting the treatment they so urgently need. The results sometimes make headlines: People with paranoia and psychotic thought processes have committed brutal acts. But more often, the reforms have… Human Rights, Health Care 2008-09-02T18:00:00-08:00 http://www.ssireview.org/articles/entry/tackling_hiv/ http://www.ssireview.org/articles/entry/tackling_hiv/ “My uncle abused me sexually,” a female soccer coach tells a group of adolescent boys and girls in Port Elizabeth, South Africa, a city with one of the highest HIV rates in the country. “I never told anybody because I was scared and didn’t understand what was happening. … I have been living with HIV for 10 years now.” Thus begins another series of Grassroot Soccer workshops, which tap into soccer’s phenomenal popularity in sub- Saharan Africa to educate kids about HIV. After telling their personal stories about how HIV has affected them, Grassroot Soccer coaches lead their students through 20 hours of educational and trust-building activities. The whole program takes place around a soccer ball. “We’re having fun dealing with a very sad thing,” says Tommy Clark, the organization’s co-founder. A retired professional soccer player, he is also a pediatrician and former research fellow in HIV prevention at the University of California, San Francisco. “The popularity of soccer in Africa is like football, basketball, baseball, and video games [in America] rolled into one,” explains Clark. But not any soccer star can teach the program. Clark finds that kids in the organization’s flagship programs in Zimbabwe, Zambia, Botswana, and South… Education, Health Care, Nonprofit Management 2008-08-05T14:00:01-08:00 http://www.ssireview.org/articles/entry/government_cares_the_most/ http://www.ssireview.org/articles/entry/government_cares_the_most/ In the early 19th century, U.S. local governments built public nursing homes to take care of their elderly residents. But now, 65 percent of nursing homes are for-profit, 28 percent are nonprofit, and a mere 7 percent are public, notes Anna A. Amirkhanyan of the school of public affairs at American University. This drive to privatize is for the worse, suggest her team’s findings in the spring 2008 Journal of Policy Analysis and Management. Their review of 14,423 nursing home inspection reports shows that public nursing homes not only provide better care, but also serve more impoverished clients than do their for-profit and nonprofit counterparts. “Maximizing quality and access is a zero-sum game for nonprofit and for-profit nursing homes,” notes Amirkhanyan. “For-profit ‘Medicaid mills’ have an incentive to offer worse care to more patients,” whereas nonprofit homes offer better care to fewer clients. “But public sector nursing homes seem to maximize both quality and access.” Patricia L. McGinnis, executive director of California Advocates for Nursing Home Reform, explains: “The key to decent care is staffing. Government nursing homes are unionized, and so have higher wages and better benefits. That leads to less staff turnover, more consistency in care, and therefore… Health Care, Government 2008-05-29T14:00:01-08:00 http://www.ssireview.org/articles/entry/marching_to_a_different_mission/ http://www.ssireview.org/articles/entry/marching_to_a_different_mission/ In January 1938, President Franklin Delano Roosevelt created the National Foundation for Infantile Paralysis (NFIP) – the forerunner of the March of Dimes. Its mission was “to lead, direct, and unify the fight” against paralytic poliomyelitis, commonly known as polio. To head the organization, Roosevelt had only one man in mind, his friend and former law partner Basil O’Connor. “I was never a public do-gooder and had no aspirations of that kind,” O’Connor later said. “But I started enjoying it.”1 O’Connor would not accept anything less than conquering polio. An autocratic leader, he built a formidable organization with a national headquarters and 3,100 county chapters. NFIP’s programs included grants for broad scientific research in viruses, cellular biology, and central nervous system disorders; professional education and training fellowships for physical therapists, physicians, and other health workers; public education about polio; and direct financial assistance for the care of polio patients. Instead of targeting big donors to support its multipronged approach, NFIP raised tens of millions of dollars from the small donations of tens of millions of Americans. The annual Poster Child, Mothers’ March, and March of Dimes fundraising campaigns rallied the nation against polio, a feared disease… Health Care, Nonprofit Management 2008-04-13T19:17:00-08:00 http://www.ssireview.org/articles/entry/poor_in_body/ http://www.ssireview.org/articles/entry/poor_in_body/ Some 17 percent of children in America live in families with incomes below the federal poverty line, according to a 2005 U.S. Census Bureau report. A minority of these children will escape poverty by the time they grow up. Even so, their bodies will still bear the marks of their early deprivations as they succumb to higher rates of cancer, infectious diseases, arthritis, and other ailments. Adults who never leave poverty suffer even worse fates, studies show. Yet no one quite understands how poverty gets – and stays – under children’s skin. In the November 2007 issue of Psychological Science, researchers plot one possible path: Poor kids are exposed to so many social and physical risks that their bodies no longer react properly to stress. Indeed, the longer they live in poverty, the worse they handle stress, says Gary W. Evans, a psychologist at Cornell University and the study’s lead author. “Poverty is not just economics and misery,” says Evans. “It has lasting, serious health effects.” To examine the links between time spent in poverty, exposure to environmental risks, and the body’s stress responses, Evans’ team of researchers tested more than 200 Caucasian children at ages 9 and 13. Half… Economic Development, Health Care, Government 2008-03-11T06:00:00-08:00 http://www.ssireview.org/articles/entry/smart_soaps/ http://www.ssireview.org/articles/entry/smart_soaps/ In June 2002 Ethiopian radios began broadcasting “Yeken Kignit” (“Looking Over One’s Daily Life”), a soap opera about a courageous heroine named Anguach and her handsome husband, Demlew. As the radio drama unfolds, Demlew’s mother meddles in the happy couple’s marriage by persuading a neighbor to seduce him. Demlew succumbs to the temptation and contracts HIV from the neighbor. Although terrified that she might also be HIV-positive, Anguach travels to her local clinic to be tested and finds out that she is negative. After loyally caring for Demlew until his death, Anguach eventually marries again and lives happily ever after. In response to the program, more than 15,000 letters poured into the offices of the Population Media Center (PMC), the nonprofit organization responsible for producing “Yeken Kignit.” One woman wrote: “After listening to your radio program, I identified myself with Anguach and took the bold decision of asking my husband to consent for a medical checkup in a local hospital. He hesitated for some time, but at last we were both tested.” When PMC founder and president William Ryerson reads letters like this, he knows his audience is hearing his organization’s social message loud and clear. Like many of the… Arts, Culture, and Religion, Health Care, Government 2008-02-01T22:05:00-08:00 http://www.ssireview.org/articles/entry/review_beyond_the_white_house/ http://www.ssireview.org/articles/entry/review_beyond_the_white_house/ Beyond the White House Jimmy Carter 288 pages (Simon & Schuster, 2007) Readers of Jimmy Carter’s latest book, Beyond the White House, will find plenty to remind them of the 39th president; the book has a dogged style and a big-hearted agenda. It is not a smooth positioning piece (Bill Clinton’s latest book, Giving, comes to mind), but it’s hard to shake the impression that Carter’s tireless efforts as a private citizen, cataloged one after another, are meant to assure his readers that he was and is more than a well-intentioned but ineffective president. Beyond the White House is divided into three main sections: “Waging Peace,” “Building Democracy,” and “Fighting Disease.” Each section breaks the Carter Center’s efforts (with President Carter at the helm) down into brief essays detailing projects undertaken and results achieved. It is a report of which any foundation would be jealous: ceasefires brokered, elections made right, diseases eradicated. Carter’s book will not set the chattering classes atwitter, but I suspect he has little interest in doing so. His farm-raised practicality is never far from sight, either in the writing itself or in the midst of the heated and complex situations it describes. There are popular writers… Health Care, Government 2008-01-13T16:12:00-08:00 http://www.ssireview.org/articles/entry/micro_franchise_against_malaria/ http://www.ssireview.org/articles/entry/micro_franchise_against_malaria/ Msimbi is 11 years old. She is one of seven children in her family, and she lives in rural Kenya. Lately, Msimbi gets tired earlier than usual, and the sun feels hotter than usual. Her head, her limbs, and her back ache. She feels weak. Msimbi has malaria. Unfortunately, she is far from alone: Malaria will affect 300 million people worldwide this year and contribute to one in five childhood deaths in Africa, according to the World Health Organization. Malaria is not the only enemy; a handful of infectious diseases – all treatable with inexpensive generic drugs – accounts for 70 percent to 90 percent of childhood illness and death in the developing world. More than 25,000 children suffering from these illnesses die every day for want of medicine. The HealthStore Foundation combines microfinance with established franchising practices to address the simple problem of “getting the drugs to sick people when and where they are needed,” says founder and CEO Scott Hillstrom. The Minneapolis-based foundation gives healthcare workers microloans to open their own for-profit Child and Family Wellness Shops (CFWshops), which distribute medical products and services to remote communities in Kenya. Applying the basic principles of successful… Health Care, Social Entrepreneurship 2007-11-27T14:00:01-08:00 http://www.ssireview.org/articles/entry/unselling_meth/ http://www.ssireview.org/articles/entry/unselling_meth/ A teenage girl rolls over on a motel bed in her underwear while an older man zips his pants. As the older man leaves the room, he hands the girl’s boyfriend a bag of methamphetamine as payment. “My boyfriend takes care of me,” says the girl’s voice. The teenage boy then sits down on the bed and puts his hand on her shoulder, just above the scabs where she clawed herself, thinking there were bugs crawling beneath her skin. This haunting television advertisement is a product of the Montana Meth Project – a public service campaign that portrays the reality of methamphetamine use, in all its grit. Funded by software entrepreneur Thomas Siebel (who founded Siebel Systems Inc.), the project’s graphic ads saturate TV, radio, billboards, and newspapers, reaching 70 to 90 percent of the state’s teens three times a week. So far, the shock factor is working. According to a report by Attorney General Mike McGrath, methamphetamine-related crime fell 53 percent during the project’s first year. Siebel, a part-time resident of Big Sky Country, first learned about the state’s drug problem from his good friend, the local sheriff, who told Siebel… Health Care, Nonprofit Management 2007-08-20T17:45:01-08:00