THE PILLARS
In this section:
Guarantees Spur Loans and Investment
Doctors Treat Cases on Web System
Low-Cost Solutions Reward Health Centers
Ghana Presents Development Award
ECONOMIC GROWTH, AGRICULTURE, AND TRADE
Guarantees Spur Loans and Investment
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Sebastian Araya Sr. and his family stand behind a table
of okra at their farm in San Benito, Nicaragua.
Jan Howard/USAID |
Commercial banks and private investors from Armenia to Zambia
are getting loan guarantees that promote development through
increased lending in areas where credit and investments were
unattainable.
Under USAID’s Development Credit Authority, the Agency
guarantees up to 50 percent of the risk of loss on an institution’s
loan portfolio. For every dollar of principal on an investment
that is not repaid, USAID shares up to 50 percent of the loss
with the lender.
The use of these partial guarantees helps stimulate development
by increasing the flow of loans and investments to areas and
activities that need it most.
The program has helped give rise to an unprecedented amount
of private financing through 143 public-private partnerships.
At the close of FY 2005, the amount of capital available to
borrowers from private-sector sources passed the $1 billion
mark.
By reducing the risk the private sector associates with
extending credit, local banks gain experience lending in underserved
sectors and to new borrowers. The goal is to develop lending
practices that continue after the guarantee expires.
In September, the Agency published USAID Loan Guarantees:
Examples and Lessons Learned, which focuses on partial
credit guarantees involving seven missions from USAID’s
portfolio of 41 countries.
In Nicaragua, Bulgaria, Vietnam, India, South Africa, Peru,
and Romania, USAID’s impact is being felt by individual
borrowers as well as by businesses, municipalities, and other
borrower groups. Each example in the report illustrates the
impact a guarantee can have on local development-oriented
activities and how it complements donor funding.
One beneficiary of the guarantee program, Nicaraguan farmer
Sebastian Araya Sr., has found that training and credit have
made a difference in his life.
“I’m not worried about competition,” he said,
“I’ve received help from USAID to improve my production.
I know I have a high-quality product.”
“USAID loan and bond guarantees, together with technical
assistance, can introduce private lenders to creditworthy
entrepreneurs in need of financing,” said John Wasielewski,
the director of the Office of Development Credit at the Bureau
for Economic Growth, Agriculture, and Trade.
“Our most basic assumption when using this guarantee
authority is that private money can be profitably invested
in enterprises and projects, which have broad-based public
benefit,” Wasielewski said. “The examples in our
new publication…are just the beginning.”
GLOBAL DEVELOPMENT ALLIANCE
Doctors Treat Cases on Web System
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A doctor donating his time through the Medical Missions
for Children telemedicine network is patched in through
a live feed to a hospital in Latin America.
Medical Missions for Children |
It was a procedure more daunting than anything the Panamanian
doctors had ever faced. Yordano, an 11-year-old boy from rural
Panama, was born with one side of his skull collapsed. He
suffered from mild retardation, had only one eye, and had
difficulty swallowing. The doctors needed help from specialists
if they were to improve his life.
Frank Brady, founder of Medical Missions for Children (MMC),
encountered Yordano in 1999, during his first trip to establish
a relationship between the Panamanian hospital and St. Joseph’s
Children’s Hospital in New Jersey. After the trip, MMC
established a system of internet video conferencing that allows
volunteer doctors from 30 mentoring hospitals in the United
States to examine, diagnose, and treat sick children abroad.
Yordano was their first case. Using its Global Telemedicine
& Teaching Network, MMC volunteer doctors took measurements
and created a virtual model of the boy’s head that helped
them rehearse the difficult operation. The network was then
used again to review the diagnosis and operation with some
50 Panamanian physicians.
In June, Yordano underwent his latest cranial reconstruction
surgery, allowing him to chew solid food for the first time.
“Nothing in my professional career has been more compelling
and gratifying than getting to know Yordano and having the
privilege of participating in his treatment,” said Dr.
Hillel Ephros, a member of the team of doctors at St. Joseph’s
Children’s Hospital that donated time to help Yordano.
“The coordination of care between his doctors here and
our colleagues in Panama was made possible through the use
of telemedicine.”
In 2003, USAID’s Global Development Alliance invested
$1 million in efforts to expand the telemedicine network throughout
Latin America and the Caribbean.
Satellite ground stations were built in Bolivia, Brazil,
Guatemala, Mexico, and Panama to allow remote communities
in these countries to receive medical education programming.
The ground stations can also store and forward up to 120 hours
of medical content for on-demand access at each of the five
USAID hospital sites.
Global communications technology company Intelsat Ltd. donated
satellite bandwidth to help establish the technology infrastructure
and add an education component in addition to real-time examination,
diagnosis, and treatment. Polycom, a leading video conferencing
company, provided video communications equipment to expand
the MMC Global Telemedicine & Learning Network.
Now a network of nearly 600 doctors volunteer a minimum
of 12 hours per year to help hospitals in developing countries
better diagnose and treat patients. Doctors’ pro-bono
consultancies, in-kind contributions of equipment, and other
donor support augment USAID’s investment by at least
four times.
“The real value of MMC’s satellite broadcast and
telemedicine program is unfolding in the months and years
that lie ahead,” said John Riehl, MMC’s chief operating
officer.
MMC has assisted more than 25,000 children through satellite
coverage worldwide. It delivers interactive healthcare consultative
services, medical education, and information to 36 countries
in Latin America, Africa, India, and Eastern Europe.
MMC partners include Johns Hopkins University, the World
Bank Group, and the National Institutes of Health.
GLOBAL HEALTH
Low-Cost Solutions Reward Health Centers
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A baby is being weighed at the Mossuril Health Center.
It is one of 11 health centers in Mozambique where staffers
were challenged to improve services without receiving
additional funding or other resources.
Marjut Korkimaki
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MAPUTO, Mozambique—When asked to help improve
11 local health centers without additional resources, a U.S.-funded
team focused at first on soap and water—in a word, cleanliness.
At the Mossuril Health Center, cleanliness of the facility
would not just reduce infections, it would make the clinic
more appealing to patients.
“[We got] over the idea that we needed money for everything,”
said Albino Marcoa, the chief general nurse and deputy director
of the health center.
“Don’t misunderstand—there is plenty that
we could do with more resources here. But this program helped
Mossuril staff focus their energies on problems they could
change by working together.”
The program, which is backed by USAID, is an effort to enhance
leadership skills and management performances of all staff
members in the Mozambique health centers and to improve efficiency.
Without a huge infusion of cash or other resources, the program
encourages health center staffers who are already working
in areas with striking poverty to reach into their surrounding
communities and work among themselves to come up with low-cost
or no-cost solutions.
The Management and Leadership for Health Sector Support
program ended recently, after two years of having a big impact
by finding solutions to seemingly small problems.
Like the health centers, the nation itself is cash poor.
About 70 percent of Mozambique’s citizens live below
the poverty level. And, while some of the country’s health
statistics show improvement, life expectancy remains low—40
for women and 38 for men—and continues to fall due to
HIV/AIDS.
At the Meconta Health Center, one of the 11, staffers focused
on increasing the number of births at the center. They polled
the community and found that expectant mothers were not coming
to the hospital because they were not assured a comfortable
place to rest. The solution was to create a designated area
for these women—a maternity waiting home.
The staff “worked together to gather materials and
recruit volunteers to do the building,” said Nerina Jone,
the center’s director. “It was a lot of work. But
now we have a new maternity waiting home.”
At the Carapira Health Center, workers count the proper
sterilization of medical equipment among their recent improvements.
At Ilha de Moçambique Hospital, the task was to install
and maintain a net to keep dust from the crumbling 400-year-old
building from contaminating medical surfaces.
And, at the Lumbo Health Center, a drive to improve hygiene
and cleanliness through the program provided a bigger pay
off. After receiving compliments from the community on the
improved facility, Lumbo Director Augusto Morgado and his
staff worked on a new action plan and approached a local NGO
for funding. “They liked what they saw. It was clear
that we had a plan, a vision, and that we had already produced
results on our own,” Morgado said.
The NGO provided funding to paint the center’s maternity
ward, intake center, administrative offices, and client kitchen.
The upshot for Mossuril and the other health centers was
learning how to stretch limited funds. “Before the project
and the leadership and management principles that we worked
on, this health center didn’t look so together,”
said Calisto Maria Sampo, Mossuril’s director.
Mossuril still needs money for a new kitchen and medical
equipment. But, Sampo says: “This program has been a
process of gaining self-confidence for all of the staff here,
and together we are going to move forward to work over our
next obstacles.”
DEMOCRACY, CONFLICT, AND HUMANITARIAN ASSISTANCE
Ghana Presents Development Award
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A Ghanian child pumps water from a well constructed
by the Adventist Development and Relief Agency (ADRA),
a long-time USAID partner.
Tereza Byrne, ADRA |
ACCRA, Ghana—A community of blind farmers west
of here, in the Jirapa district, has increased its income
from vegetable growing tenfold since the Adventist Development
and Relief Agency (ADRA) offered its helping hand.
Farmers’ income shot up from $55 to $550. The increase
in food production and its use contributed to reducing malnutrition
among children under five by 10 percent between 2002 and 2005.
ADRA, a longtime USAID partner here, has also provided the
Jirapa farmers with clothes, blankets, and other assistance.
Ghana’s Excellence Awards Foundation recently gave
ADRA its International Development Partner award, an honor
bestowed on organizations whose activities point toward international
cooperation and sustainable development for Ghanaians.
ADRA receives about $4.4 million annually through USAID’s
Food for Peace program. A major portion of the food—primarily
wheat—is sold in Ghana to generate local currency. ADRA
then uses the money to train rural farmers in improved agricultural
practices and provide items such as seedlings for orchards
and reforestation.
ADRA also helps communities to fix up roads so that farmers
can reach markets more easily, and it upgrades potable water
and sanitation facilities.
Corn yields in targeted areas have risen from 400 kilos
in 2002 to 959 kilos this year. Mango production has also
jumped from 700 kilos per acre in 2002 to 2,704 kilos per
acre.
In Jirapa, farmers’ increased vegetable productivity
is boosting the local fruit-processing industry, leading to
exports and providing jobs. In eastern Ghana, for example,
cultivation of exportable mangos has created more than 5,000
jobs.
“ADRA/Ghana’s activities are directed to food
insecure areas and directly benefit over 300,000 people,”
said Jonathan Dworken, acting director of Food for Peace.
“Over the years, food sufficiency and rural incomes for
this poorer target group have remarkably improved, and disease
incidence has reduced. This, we believe, is the result of
ADRA’s work.”
The organization was created in 1983 by the Seventh-day
Adventist Church to provide disaster assistance to poor communities
around the world. That same year, USAID began funding ADRA
through food aid, when Ghana suffered from a severe food shortage.
Since then, the group has received funding for various projects
in the agriculture and health sectors. Today, the group works
in 125 countries. Some 90 percent of its donations are used
for humanitarian aid.
The award was presented Aug. 19. Dignitaries such as U.N.
Secretary General Kofi Annan and Ghanian President John Kufuor
attended the ceremony.
The USAID mission here received the foundation’s inaugural
award in 2000.
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