Empowering the Powerless Through Scalable Philanthropy

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Our 4x4 rumbled along a bumpy dirt track, and as it finally reached the crest of the last green and invitingly lush hill, we could see the azure blue sky plunging into the Indian Ocean, where swells of rolling waves revealed breaching humpback whales. It was one of the most stunning views I had ever seen. We had finally arrived in Coffee Bay in the Eastern Cape of South Africa after a 9 hour journey from Johannesburg. This is the place where the famous footage from Blue Planet 2 of the great sardine run overwhelmed by dolphins was shot. But sardines were not why we were here. The Eastern Cape is the most deprived part of South Africa. Unemployment is sky high at 40-50%, and HIV rates in expectant mothers are 29%, putting a whole new generation at risk. What.a.contrast.

We were halfway through a week-long trip organised by UBS Optimus Foundation, visiting 3 NGOs, all operating with different purposes. I looked forward to the learning experience, as I have a very limited experience (zero really!) of NGO work and philanthropy. Like a lot of people, aid in the form of “pouring money down a black hole” is something I don’t believe in or support. After many years it felt like there was change in the air in the NGO sector. This was reinforced by Robbie Brozin, the South African founder of Nando’s, who spoke very eloquently at the first night’s dinner, stating “Africa doesn’t need another T-shirt”. He is very involved in a variety of NGO initiatives, and talked about the need to create real change by scaling the preexisting local ecosystems that have some funds, but haven’t yet delivered true results. My question entering the week was - “is it possible to scale and accelerate a change supported through philanthropic work, delivered by NGOs and sustained by local governments?” Here is what I found with one of the NGOs based in Coffee Bay.

One to One - the Enable project. The original objective (now expanded) for this project was to ensure a 100% success rate preventing transfer of HIV from expectant mothers. 40% of expectant mothers who were HIV positive didn’t take AVR (antiretroviral drugs) when the project started. This was largely due to a lack of education, and partly related to those drugs not being available. The focus was on these HIV positive mothers and saving future generations. The most incredible thing here is that this is a fairly fixable problem. Proper use of ARVs will bring the level of HIV in newborns down to near zero. Availability of medicine is a problem, but it exists and the government funding is there, albeit poorly deployed.

Enable has since expanded to also track malnutrition in children, secure birth certificates to enable grants to be paid out, and drive people to the nearest hospital (£50 / $65 one way which is a lot of money for someone living on the poverty line).

One to One - Scale and accelerate:

What was the big idea to solve this solvable problem? Recruit the locals. One to One went out and found 30 exceptional local women and sent them on a 6 week training course to give them essential training on how to provide basic healthcare. They created a health toolkit, plonked it in a rucksack and built a centre in Coffee Bay from which to coordinate activities. We met these women and their enthusiasm, drive and determination was incredible. When you give people purpose, education and the right tools, they can move mountains. Speaking of mountains, they do all their work on foot, trekking up and down steep hills, walking door to door for their at-home visits. These women had very little prior education, were mostly HIV positive themselves, and were living hand to mouth. They are called Community Health Workers (CHW), and their work has transformed local health provision in the area. Since engaging three years ago, they have had a near 100% success rate in terms of preventing transfer of HIV to newborn babies. Unbelievable.

The platform built and provided by the Enable Project will be expanded through further donations and it is readying itself to be eventually handed over to local governments to run. The solution of Community Health Workers is a scalable solution which can be accelerated and deployed in other parts of South Africa as well as other countries where local basic healthcare is lacking.

The Enable Project has expanded beyond HIV transfer prevention, now tracking malnutrition issues in children under 5, helping with hospital transports, ensuring births are properly registered (enabling future grants / hospital care). Their impact has already been substantial (see their website for more info). The CHW scheme not only helps with healthcare, it also fuels the local economy by creating more wage-earners spending money in all corners of the market.

A new generation of nurses trained to create a new HIV free generation, which in turn will spur on a thriving local economy in this truly stunningly beautiful part of the world. This is a great example of an NGO using donations in a clever way to design and deliver an innovative, sustainable platform that can be onboarded by local government and make a huge difference to a long neglected local population.

I was truly inspired by these local women and what the project has achieved. It is a moral obligation that we take our knowledge from established economies to help stimulate independently functioning local communities. Aid money will not be enough if we don’t find a way of scaling and accelerating local resources. I personally look to get involved and contribute my time and experience in scaling and accelerating platforms and apply that to organisations such as One to One / Enable project.

SK Qnary