Archives by date

You are browsing the site archives by date.

Why ‘Solutions Journalism’ Matters, Too

By David Bornstein

On Friday, I did a recap of stories that we had featured in Fixes over the past year ― and I was surprised to discover that many of the organizations we’d written about had managed to expand their work, even in a difficult economy and political context. Looking back at the range of changes that had occurred during the past year, I was reminded of the remark by Robert Kennedy: “Each time a man stands up for an ideal, or acts to improve the lot of others, or strikes out against injustice, he sends forth a tiny ripple of hope, and those ripples build a current which can sweep down the mightiest walls of oppression and resistance.”
Read More

News Flash: Progress Happens

By Tina Rosenberg

The benefit of writing a column about solutions is that it provides an alternative lens through which to view the world. The daily news tends to be dominated by daunting challenges (unemployment, climate change, the polarization of Congress) and flashpoint events (the killing of Osama bin Laden, the tsunami in Japan, the Penn State scandal). These stories are vital to cover. However, people often come away from the news with a lot more information about problems than about how society is dealing with them.
Read More

To Maintain Water Pumps, It Takes More Than a Village

By Tina Rosenberg

Readers responded with many practical ideas and incisive comments — some of them speaking from sad experience — to last Friday’s Fixes column on the sustainability of water pumps.  I wrote about a new program started recently by WaterAid in the north of India.  It trains local people, including many women, to repair water pumps. They now run businesses that charge villages low fees for quick, guaranteed and reliable repairs when their hand pumps break down.
Read More

Keeping the Water Flowing in Rural Villages

By Tina Rosenberg

Keeping projects in business for the long term has been a constant theme of the Fixes column, and if sustainability has a poster child, it would be a water pump. Travel anywhere in Africa or South Asia or Central America, and you will find a landscape dotted with the rusting skeletons of dead water pumps or wells..

In most developing countries, these water points are installed with great fanfare by the government or a charitable group. They greatly improve the lives of villagers. Having a water point in or near the village means that women don’t have to spend 6,8, even 12 hours a day on perilous journeys to fetch water from rivers or lakes. The pumps allow girls to go to school instead of staying home to help their mothers fetch water or take care of siblings. They allow villagers to drink reasonably clean water instead of risking their health with every sip.
Read More

Safety Nets for Freelancers

By David Bornstein

In this country, three subjects that are guaranteed to generate a heated debate are religion, politics and, you guessed it, health insurance. Of the first two, Mark Twain observed that “people’s beliefs and convictions are in almost every case gotten at second-hand.” When it comes to health insurance, people speak from direct experience ― and pain. The numerous comments to Friday’s columnabout the Freelancers Union ― which brings together freelance workers to increase their power in markets and politics ― reveal that many independent workers feel that the battle for affordable health insurance is one they are losing.
Read More

Health Care for a Changing Work Force

By David Bornstein

Big institutions are often slow to awaken to major social transformations. Microsoft was famously late to grasp the importance of the Internet. American auto manufacturers were slow to identify the demand for fuel-efficient cars. And today, the United States government is making a similar mistake: it still doesn’t seem to recognize that Americans no longer work the way they used to.
Read More

Giving Where It Works

By Tina Rosenberg

At Fixes, we often argue that good ideas are plentiful — but ways to keep them going are hard to find. That’s why we pay a lot of attention to sustainability, especially financial sustainability. Life is always precarious for programs that depend on government financing or charitable donations, particularly so today. So we choose many of the programs we highlight because they have found a creative new way to sustain good work, often through combining social and for-profit missions.
Read More

An Electronic Eye on Hospital Hand-Washing

By Tina Rosenberg

Beeps and blinking lights are the constant chatter of a hospital intensive care unit, but at the I.C.U.’s in North Shore University Hospital in Manhasset, N.Y., the conversation has some unusual contributors. Two L.E.D. displays adorn the wall across from each nurses’ station. They show the hand hygiene rate achieved: last Friday in the surgical I.C.U., the weekly rate was 85 percent and the current shift had a rate of 91 percent. “Great Shift!!” the sign said. At the medical I.C.U. next door, the weekly rate was 81 percent, and the current shift 82 percent.
Read More

Lessons in Transit Innovation

By Lisa Margonelli

Reader responses to last week’s column about transit innovation revealed a lot of love for transit: Readers reported their appreciation for light rail in Trenton, N.J.; buses in Austin, Tex.; the pedicabs of the Philippines; the transit planners of Portland, Ore.; dollar vans in Ghana and Guatemala; the SLUGS of Washington D.C. (an informal car pool system); and the Skytrain and songthaews — pickups with benches in the back — of Bangkok.
Read More

Thinking Outside the Bus

By Lisa Margonelli

Until September of 2010, Pam Boucher’s life was small. Living in Brunswick, Me., a rural town of 21,000, she was dependent upon others to move. At the time, she used crutches or a walker to get around and seizures prevented her from driving. She’d get rides to medical appointments from a social service agency. Trips to buy groceries, or visit her husband in a nursing home, required the help of her adult sons or scheduling a social service staff member. A trip to the local Wal-Mart would cost $28 in taxi fees. Socializing outside her apartment was pretty much impossible. “I was very limited,” she says.
Read More

For Weight Loss, a Recipe of Teamwork and Trust

By Tina Rosenberg

On Friday I wrote about Saddleback Church, which is using its small groups as an infrastructure to help its members lose weight and live healthier lives. The megachurch has megaplans for this idea — the church’s pastor, the Rev. Rick Warren, hopes to expand it through the worldwide network of thousands of churches that are affiliated with Saddleback and the 150,000 pastors who subscribe to his newsletter.
Read More

At a Big Church, a Small Group Health Solution

By Tina Rosenberg

About a year ago, Rev. Rick Warren, the pastor of Saddleback Church in southern California, was conducting a baptism when he noticed something. As with everything at this megachurch, with some 30,000 members, baptisms are large events — this time, 858 people were being baptized. “Along about 500 I thought — this is my honest truth, it wasn’t a very spiritual thought — we’re all fat,” Warren told his congregation later. “I know pastors aren’t supposed to be thinking that when they’re baptizing, but that was what I thought: we’re all fat. But I’m fat, and I’m a terrible model of this.”
Read More

Outsourcing Is Not (Always) Evil

By David Bornstein

On Friday, I wrote about two social enterprises ― Samasource and Digital Divide Data ― that extend computer-based employment to people with modest educations in developing countries. The strategy of harnessing the Internet to bring low-cost data management jobs to remote and impoverished communities has been called “impact sourcing.” Some estimate that the market for these services, $4.5 billion today, could rise to $20 billion by 2015, providing jobs to 780,000 people (pdf, p.14).
Read More

Workers of the World, Employed

By David Bornstein

More than 60 percent of the world’s gross domestic product comes from global trade. This is double what it was in the 1980s. Most economists agree that the astonishing increase in trade over the past quarter century has boosted economic growth and job creation, and, in many countries, led to a decline in absolute poverty. But while the economic superhighway has spread around the globe, in many parts of the world there are still not enough on-ramps.
Read More

How to Feed the Hungry, Faster

By Tina Rosenberg

On Friday, I wrote about how people in Dhobley, Somalia, are getting emergency food despite a guerrilla war that is keeping out aid workers ― and food.  Instead of trucking in sacks of food, World Concern and its partner, the African Rescue Committee, distribute  vouchers that people in Dhobley use to buy what they need from local merchants.
Read More

In Famine, Vouchers Can Be Tickets to Survival

By Tina Rosenberg

The town of Dhobley, Somalia, sits at the gateway of hell.  Just west of Dhobley is the border with Kenya, and the road to Dadaab, which hosts a giant complex of refugee camps; Dhobley has become the last stop in Somalia for a growing stream of desperate, starving people in flight from famine.  In Dhobley, as well, drought has ruined crops and felled cows.   There is no government to help.  The town is a battleground; control of Dhobley has teetered between the Shabaab Islamist militant group and government forces.  Shabaab has blocked food aid from entering Dhobley and burned a food truck, but soldiers from all sides have stolen food meant for the destitute.   The usual street life of an African village — children playing, women laughing together — has vanished.   Gunshots are a constant background noise — “like birds singing,” said Tracy Stover, the emergency coordinator in Dadaab for the humanitarian group World Concern.
Read More

Moving Beyond the Cold War Coach

By David Bornstein

Youth sports in the United States is a contradiction. In surveys, parents overwhelmingly say that youth sports should emphasize values like teamwork, honesty, discipline and fair play. But when adults are asked what values they think youth sports actually reinforce most, they say competitiveness and the importance of winning.
Read More

The Power of Positive Coaching

By David Bornstein

Imagine you’re coaching a big soccer game, against an undefeated team that has beaten your team in all your previous matches. Your 11-year-olds are playing well and are ahead. Then, in the closing minutes, the official makes a bad call that goes against you and, because of it, you lose. After the game, the parents of your players scream at the official. The kids are disappointed, looking up at you. What do you do?

Or you’re coaching tee-ball and one of your 5-year-old players has failed to get a hit so far. Now, he’s up again in a crucial situation and is nervous. All eyes are on him. His first swing misses high. The second misses low and knocks the ball off the tee. You call him over to offer some help. What do you say?
Read More

Where Teenagers Find the Jury Isn’t Rigged

By Tina Rosenberg

On Friday, Fixes examined the Youth Court of the District of Columbia, a forum where first-time nonviolent teenage offenders are judged by others who have been in the same situation.   The D.C. Youth Court is one of the largest of some 1,000 youth courts around the country.   These courts are designed to help minor offenders avoid a criminal record and stay out of juvenile justice — traditionally an efficient production line for criminality.

While most commenters praised youth courts for taking a humane approach, reader Beliavsky from Boston (7) wrote, “Letting young criminals (excuse me, ‘troubled youths’) be judged by other young criminals does not seem right to me. There should be a real, non-criminal, adult, judge.”
Read More

For Young Offenders, Hope in a Jury of Their Peers

By Tina Rosenberg

Juvenile justice is a field where the cure aggravates the disease. Take a kid of 15 or who shoplifts, gets into a fight, is caught with marijuana or is out at night spray-painting graffiti with a gang. He’s no hardened criminal — yet. After a tour through the juvenile justice system, however, he may well be. He’ll be mixed in with real criminals, in an environment where violence is the only path to respect. He’ll understand what society expects of him: more crime. Perhaps most important, he’ll have a criminal record — a major deterrent to getting a job.

On Saturday mornings at the H. Carl Moultrie Courthouse of Washington D.C.’s Superior Court, an alternative form of justice is at work. In the ground-floor courtrooms there are trials going on — with juries, defendants, bailiffs and judges. But everyone involved is a teenager.
Read More

Forging a Life-Changing Bond

By David Bornstein

On Friday, I reported on an organization called Friends of the Children, which identifies children in kindergarten growing up in poverty and facing multiple risk factors at home and in their neighborhood — and then connects them with adult mentors for 12 years. The idea is to guarantee that these children have a consistent relationship with a caring and responsible adult whom they see at least four hours each week, from kindergarten until high school graduation.
Read More

For Children at Risk, Mentors Who Stay

By David Bornstein

Samuel was out of control. He cursed at his teacher, refused to do school work, attacked other kids in the schoolyard — and Samuel was still in kindergarten. His home life was chaotic. He’d never met his father. His mother had emotional and drug problems and was unable to care for him. His grandmother did her best. His older brother was involved in violent crime and had been in and out of jail. He taught Samuel to smoke marijuana when he was 6 years old.

If this story had continued on its trajectory, Samuel (not his real name) would have likely been one of the million American students who drop out of school each year. He would be at serious risk of getting entangled in the justice system and becoming a young parent who perpetuates the cycle of neglect and violence.
Read More

Quick Change That Lasts for the Long Term

By Tina Rosenberg

On Friday I wrote about Rapid Results Initiatives, bite-sized pieces of social change that a village, government office or business will choose and try to accomplish in just 100 days.   Rapid Results Initiatives have proven to be effective at various tasks: improving  health, infrastructure, education —  service delivery of any kind.  The urgent deadline provides focus.  It’s no longer business as usual, plagued by the usual list of reasons why nothing gets done.
Read More

Making Change Happen, on a Deadline

By Tina Rosenberg

The PreFabricated Building Parts Production Enterprise in Addis Ababa is a state-owned company that makes concrete walls and other structures, mainly for the Ethiopian government’s low-cost housing program. Public-sector construction companies in the third world are not generally known for energy, flexibility, risk-taking or creative thinking. PreFabricated, in other words, does not seem like the kind of business that would or could do astonishing things in a hurry.

Like many companies in AIDS-wracked Ethiopia, PreFabricated had an AIDS policy, which included extra pay for its H.I.V. positive workers so they could buy more food. In March, 2008, the company decided to do more. It set a goal of persuading 70 percent of its employees — 700 people — to get tested for H.I.V. in 100 days.
Read More

Drugs, Risk and the Myth of the ‘Evil’ Addict

By Tina Rosenberg

My column on making Naloxone available over-the-counter to reverse overdoses drew many plaudits and two main strands of criticism. One group argued that addicts aren’t worth saving and we need to cut the drug supply; the other said that Naloxone, also known by its brand name, Narcan, is too risky to be available without a prescription.

Let me address the second argument first. More than 50,000 Naloxone kits have already been distributed to drug users, pain patients and their loved ones in the United States and 10,000 successful overdose reversals have been reported.
Read More

For Many, a Life-Saving Drug Out of Reach

By Maia Szalavitz

Mark Kinzly saved two lives this week. But he wouldn’t have been here to help if a friend hadn’t once done for him what he’s now repeatedly done for others — provide overdose victims with Naloxone, the antidote that revived them.

Overdose now kills more people in the United States than car accidents, making it the leading cause of injury-related mortality according to the latest statistics from the Centers for Disease Control and Prevention. The number of deaths — 37,485 in 2009 — could be cut dramatically if Naloxone were available over-the-counter and placed in every first aid kit.
Read More

The Health Payoffs of Time Banks

By Tina Rosenberg

Friday’s Fixes post about time banks resonated with readers.  Time banks are local organizations that allow people to use their skills to help others by exchanging hours instead of money. You earn time dollars by, say, taking a neighbor to the doctor, and spend those time dollars on the same number of hours’ worth of other services, such as computer repair or singing lessons.  Strikingly, very few readers talked about what they could get from time banks; most  responded to the possibility of giving.  “The chance to help others and feel good about myself makes the bargain seem better than I thought possible,” wrote Ajasys from Vancouver, Wash. (41)  — a typical comment.
Read More

Where All Work Is Created Equal

By Tina Rosenberg

School went badly last year for José, Angel and Estefani. The 8-year-old twins and their 7-year-old sister are recent immigrants to the Washington Heights neighborhood of Manhattan. In part because they didn’t speak much English, late in 2010 all three were notified they were in danger of failing.

But their fortunes changed in January. They began going to the Fort Washington Library every Saturday for two hours of one-on-one tutoring from Elayne Castillo-Vélez, her sister, Sharon Castillo, and their grandmother, Saturnina Gutiérrez. The children had lost confidence and didn’t feel that more hours spent with school books would produce anything, said Castillo-Vélez. “There were times when all they wanted to do was talk about their week,” she said.
Read More

Rock Is Not the Enemy

By David Bornstein

On Friday, I wrote about an organization called Little Kids Rock, which has helped to revitalize and broaden music education in more than a thousand schools by encouraging children to learn to play popular music, form bands and compose their own songs. The column sparked a little bit of a culture war: some readers were aggrieved by the idea that children should learn popular music in schools, others suggested that classical composers would love rock ‘n roll. Some feared that teaching pop would “dumb down” music education, others felt it was vital to make music education more relevant to children. I’d like to clarify some misconceptions and explain why I think the program is a valuable addition, rather than a threat to the classical tradition.
Read More

Beyond Baby Mozart, Students Who Rock

By David Bornstein

With school underway, I asked my eight-year-old son this week if he had any interest in learning guitar. He said he’d prefer the piano. I was pleased, but hesitant. I had my own stint with after-school piano lessons at age eight — plinking out notes from classical pieces that were foreign to me. My progress was agonizingly slow and I gave up within months.

Music education hasn’t changed fundamentally since the 1970s. Students are still taught to read notation so they can recite compositions that they would never listen to on their MP3 players or play with friends. The four “streams” in music education — orchestra, chorus, marching band and jazz band — have remained constant for four decades, while a third generation is growing up listening to rock and pop music. And my experience as an eight-year-old is all too common. Many children quit before making progress with an instrument, then regret it as adults. Others play violin or trumpet for the school orchestra or band, then drop the instrument after graduating from high school.
Read More

Beyond Refugee Camps, a Better Way

By Tina Rosenberg

In Friday’s Fixes column, I wrote about alternatives to keeping refugees in camps for years. The hundreds of thousands of Somalis streaming today into the camps in Dadaab, Kenya, are getting lifesaving food, medical care and shelter.  Camps like Dadaab are designed for emergency care and do it well — but most refugee situations are long-term.   Camps condemn refugees to years, maybe decades, of dependency.  There are people in Dadaab who have not stepped outside the camp since it opened in 1991.
Read More

For Refugees, the Price of Dignity

By Tina Rosenberg

Somalia is now suffering its worst drought in 60 years. A quarter of the population has fled famine and conflict, heading west into Kenya. More than 1,300 people a day stream into the complex of refugee camps at Dadaab, Kenya, which is now housing more than 430,000 people in camps designed for 90,000. Many Somalis arrive near death after journeys of weeks with little food. Large numbers of them are children, often without parents.
Read More

Making Medical Donations Work

By Tina Rosenberg

In Friday’s Fixes column I wrote about organizations that collect usable surplus equipment and supplies from hospitals in the United States and ship it to hospitals that need them in poor countries.   Readers were generally enthusiastic about the environmental and health benefits of this idea, but some offered important cautions. Homira from Wash, D.C. (15) wrote:  “There are a slew of complex issues that make donations of any kind aside from financial  really poor practice for trying to help developing countries. When it comes to medical equipment donations, the consumables necessary to operate many of these machines, such as x-ray film, reagents, etc,  are often not considered prior to the donations; nor is life-cycle costing and maintenance and operational costing and support figured in. Subsequently we see a lot of discarded medical equipment lying around clinics, hospitals and dump sites in low-income countries we work in.”
Read More

Making Low-Interest Auto Loans Work

By Lisa Margonelli

David Bornstein and Tina Rosenberg are on vacation.

Last week I wrote about the New England-based program More Than Wheels, which helps people get low-interest loans on new or good used cars, and allows them to save money on repairs, gas and financing. Most of the commenters — especially those who live in rural areas — liked the idea of the program, but there were a few persistent questions and issues:

Are cars necessary?
Read More

On the Road, and Out of the Red

By Lisa Margonelli

David Bornstein and Tina Rosenberg are on vacation.

In March 2010, Tammy Trahan’s 1993 Jeep Cherokee broke down on one of the New Hampshire back roads that made up her 90-mile daily commute. “I was in tears,” says Tammy, “I wanted to drive into the river.” As a single mom, the car was her lifeline, taking her to the job that kept her and her family barely afloat. But the car was also dragging her down. Because a bad divorce had left her with terrible credit, she’d paid such high interest rates that the car with a $9000 sticker price when she bought it seven years earlier ended up costing her $20,000 in payments. She’d also paid many thousands of dollars in repair charges. Gasoline for the behemoth cost her as much as $500 a month. Despite the fact that she worked full time and had as many as four side jobs, she had no savings at all, and the latest breakdown meant she’d be late for work again. On that cold morning by the side of the road Trahan despaired: “I was afraid I’d be in the same rut forever.”
Read More

Salvaging Medical Cast-Offs to Save Lives

By Tina Rosenberg

When Dr. Bruce Charash arrived in Cotonou, Benin, in May 2007, he went from the airport to Hubert Maga Hospital.  Charash is the founder of a Brooklyn-based organization called Doc2Dock, which collects surplus medical equipment from hospitals in the United States and ships it to hospitals in poor countries.  As Charash’s plane was landing, a container of medical equipment and supplies had docked, destined for Hubert Maga.
Read More

Slashing the Price of Health With Common Sense

By David Bornstein

As health care costs continue to spiral out of control, it’s often forgotten that one of the best ways to lower health care expenditures is to reduce the amount of medical care that’s needed to keep people healthy. This is no revelation. However, because of the financial incentives in our health system, the things we can do to promote health, and prevent illness, are not prioritized.
Read More

Treating the Cause, Not the Illness

By David Bornstein

In 1965, in an impoverished rural county in the Mississippi Delta, the pioneering physician Jack Geiger helped found one of the nation’s first community health centers. Many of the children Geiger treated were seriously malnourished, so he began writing “prescriptions” for food — stipulating quantities of milk, vegetables, meat, and fruit that could be “filled” at grocery stores, which were instructed to send the bills to the health center, where they were paid out of the pharmacy budget. When word of this reached the Office of Economic Opportunity in Washington, which financed the center, an official was dispatched to Mississippi to reprimand Geiger and make sure he understood that the center’s money could be used only for medical purposes. Geiger replied: “The last time I looked in my textbooks, the specific therapy for malnutrition was food.” The official had nothing to say and returned to Washington.
Read More

A Trade Barrier to Defeating AIDS

By Tina Rosenberg

In Friday’s Fixes column, I wrote about the Medicines Patent Pool, a new organization trying to make AIDS drugs better, cheaper and available sooner to people who need them in poor countries.   It relies on voluntary donations of rights by patent holders, most of them pharmaceutical companies.   Its success is crucial;  new research shows that if we can dramatically increase the number of people on antiretroviral medicines, we can not only save millions of lives, but potentially cause the epidemic to die away.
Read More

Sharing Patents to Wipe Out AIDS

By Tina Rosenberg

Not since the announcement in 1996 that antiretroviral therapy could effectively control H.I.V. has there been a season of AIDS news as hopeful as this one.  Trials of a new microbicide have brought positive results; ongoing studies of circumcision are showing that it gives strong, lasting, protection; a man has been cured of H.I.V. infection and new animal and clinical trials are raising hopes that he won’t be alone.
Read More

Trusting Families to Help Themselves

By David Bornstein

On Friday, I reported on the Family Independence Initiative (F.I.I.), an organization that encourages low-income families to define their own goals and work towards them in mutual support groups, while carefully documenting their successes. (F.I.I. pays modest stipends for the research data provided by families.). So far, the few hundred families that F.I.I. has worked with have demonstrated impressive gains in areas like income and savings, debt reduction, skills training, and improvements in children’s grades and health care.
Read More

Out of Poverty, Family-Style

By David Bornstein

Courtesy of Family Independence Initiative

A Family Independence Initiative gathering in Boston.

Shortly after Candace Keshwar immigrated from Trinidad to Boston in 2002, her life took a difficult turn. Her dream had been to go to college and have a career where she could help others. But her first daughter was born with cerebral palsy and Keshwar spent the next seven years caring for her at home. She grew isolated. Her husband worked in construction, but jobs were sporadic, and the family relied on government assistance. “It was a real dark space for me,” Keshwar said. “I kept thinking, ‘This cannot be my life. I know I have the potential to do so much more.’”
Read More

Friends in Revolution

By Tina Rosenberg

Associated Press

Policemen in plain clothes arrested a protester during clashes in Egypt on April 6, 2008.

On Friday, I wrote about Friendfactor, an organizing tool used in the successful battle for gay marriage in New York State. Friendfactor combines social media and real-world friendship to motivate people to get active. Instead of getting an e-mail from a group asking you to support a political goal, you get one from a close friend or family member asking you to “help me get my full rights.” Friendfactor is particularly interesting because it seems to offer a solution to one of the biggest obstacles in using social media for political change: people need close personal connections in order to get them to take action — especially if that action is risky and difficult.
Read More

On Gay Rights, Moving Real-Life Friends to Action

By Tina Rosenberg

Friendfactor.org

Sarah Silverman’s page on Friendfactor.org

The successful battle for gay marriage legislation in New York State involved the debut of an intriguing new way to apply social media to social change: Friendfactor. While the precise role it played in the law’s passage is unclear, Friendfactor offered a new model for online organizing that could become very useful in similar rights campaigns.

Although Friendfactor depends on social media to contact people, the strategy it used to support gay rights differed in important ways from the supposed Twitter and Facebook “revolutions” we have read so much about: it capitalizes on the strong bonds of real friendship — the old-fashioned sort that exists offline — to move people to action.
Read More

Building a More Inclusive Work Force

By David Bornstein

In recent years, there has been a dramatic rise in the diagnosis of autism spectrum disorders (A.S.D.). The Centers for Disease Control and Prevention estimates that 730,000 people in the U.S. under age 21 have an A.S.D. It’s much harder to estimate the number of adults on the autism spectrum because only in recent decades has the condition been regularly diagnosed.
Read More

For Some With Autism, Jobs to Match Their Talents

By David Bornstein

Thorkil Sonne

A sketch, right, of an index page in a book of maps, drawn from memory by the 7-year-old Lars Sonne, who has autism, showed a talent for visual reproduction.

Steen B. Iversen tests mobile phones for the Danish telecommunications firm TDC. Before landing his job two and a half years ago, Iversen, 50, who has been diagnosed with Asperger’s Syndrome, spent more than 12 years looking for work. “It’s always been somewhat traumatizing,” he said. “I have had jobs, but I always got fired. People would laugh about me behind my back and laugh at me to my face. Those problems have more or less been a problem for me from childhood.”

In the working world, Iversen said, his biggest problem was communication. “Most of the time it simply was that people didn’t understand me and I didn’t understand them,” he said.
Read More

Keeping Artificial Limbs Low-Cost, and High-Quality

By Tina Rosenberg

In response to Friday’s column about the Jaipur Limb, an inexpensive, locally-made artificial leg that has helped millions of impoverished people in poor countries to regain their dignity and livelihood, Laurie C. from Marina,Calif., (5), a reader who uses a wheelchair, made an important point: “It can be scary to know that you live in a body that is so dependent on inanimate equipment that if you don’t have that equipment, you basically fall off the radar of life itself,” she wrote. “You disappear from society, people avoid you, you become ‘a burden’ … all for the lack of a piece of equipment.” This is a very persuasive argument for why a low-cost wide-scale product like the Jaipur Limb is necessary.
Read More

Helping the Lame Walk, Without a Miracle

By Tina Rosenberg

Courtesy of Don Short

A Jaipur limb.

They come in on crutches, on homemade wheeled dollies, crude peg legs, even carried on the backs of mothers or brothers. Even with all their limbs they would have been impoverished, and losing a leg robbed them of the ability to carry out the subsistence labor the poor do all day to stay alive. They are reduced to begging or burdening their families.

A few hours or days later they leave on two legs, walking back to self-sufficiency. They can now carry water, farm two acres, drive a bicycle taxi. They can run and climb mountains and trees.
Read More

In Iran, a Brotherhood of Doctors and Patients

By Tina Rosenberg

Courtesy of the Global Health Council

Kamiar Alaei accepting the Jonathan Mann Award for Health and Human Rights.

Few doctors anywhere in the world have done their country a greater service than the Iranian brothers Arash and Kamiar Alaei. Kamiar, who is 37, is currently living in Albany, N.Y., where he is working on a doctorate in public health. Arash, who is 42, is a resident of Tehran’s notorious Evin prison — where until recently, Kamiar lived as well.
Read More

The Rewards of Renewal

By David Bornstein

Toby Jorrin

Michelle Obama, working with KaBOOM! Senior Project Manager Kathryn Lusk, added a photo of the 2000th KaBOOM! playground to the group’s mobile app.

In “Self-Renewal,” a landmark book on how societies innovate, John W. Gardner wrote that the task for every new generation was not to “stand a dreary watch over the ancient values” but to face the “bracing truth that it is their task to re-create those values continuously in their own behavior, facing the dilemmas and catastrophes of their own time.” Society, he added, was not “like a machine that is created at some point in time and then maintained with a minimum of effort; a society is being continuously re-created, for good or ill, by its members. This will strike some as a burdensome responsibility, but it will summon others to greatness.”
Read More

Mobilizing the Playground Movement

By David Bornstein

Courtesy of KaBOOM!

During KaBOOM!’s “design days,” children are encouraged to draw their ideas for a playground.

On Wednesday more than 500 volunteers will gather at the Imagine Southeast Public Charter School, in Congress Heights, one of Washington’s poorest neighborhoods, to help construct the 2,000th playground led by KaBOOM!, an organization that has turned community playground building into the modern-day equivalent of barn raising. Among those assembling slides and swing sets alongside residents and Americorps volunteers will be Michelle Obama and Secretary of Education Arne Duncan who will be highlighting the importance of play and the administration’s Let’s Move initiative, which aims to attack the problem of childhood obesity.
Read More

Out of Prison, Into a Vicious Circle of Debt

By Tina Rosenberg

On Tuesday, I wrote about the Clapham Set, a Boston program that works with recently released prisoners. It asks judges to waive their court fees if the prisoners complete an academic course and work with a coach who helps them get jobs and services they need to turn their lives around.
Read More

Paying for Their Crimes, Again

By Tina Rosenberg

When a young man gets out of prison, society has an interest in keeping him out. Helping him to live a law-abiding life benefits everyone: the ex-con and his family and friends, the people who might otherwise have become his victims, and taxpayers, as a year in prison usually costs upwards of $30,000.
Read More

A Way to Pay for College, With Dividends

By David Bornstein

If you were a student looking for financing to pursue a degree in social science, would you accept an offer of $16,000, in exchange for paying 4.5 percent of your income for 10 years after you graduate?

In Tuesday’s column, I wrote about a social enterprise called Lumni, which helps predominately low-income students in Colombia, Mexico, Chile and the United States finance their college educations through “human capital contracts.” In exchange for the financing they receive, the students commit to repayment schemes along the lines of the one outlined above (the terms vary). After the time period elapses — it’s always 10 years or less — the obligation expires, no matter how much has been repaid. Some readers thought this could be an attractive alternative to student loans, but many others had strong negative reactions. I’d like to address their concerns.
Read More

Instead of Student Loans, Investing in Futures

By David Bornstein

Courtesy of Lumni

Krystal Shipley, a sophomore at the University of Redlands, received financing from Lumni this year

As the global economy has become more knowledge-based, the importance of a university education has risen dramatically. However, only 7 percent of the world’s population currently has a college degree. There are many reasons why people fail to reach college, including, of course, lack of access to quality primary and secondary schooling. But for millions of students who could succeed in college, the limiting factor is money.
Read More

The Path From Charity to Profit

By Tina Rosenberg

Thatcher Cook for Mercy Corps

Indriyati, 31, fed her daughter Aurelia, 20 months, porridge-style chicken and vegetables from the KeBal food cart.

On Tuesday I wrote about Kedai Balitaku, a for-profit company started last year by the development group Mercy Corps in Indonesia. Mercy Corps took this unusual step because it realized that its programs to educate mothers about nutrition were not changing what mothers fed their children. Healthy food is expensive, and the crowded conditions in the Jakarta slums mean that many families have no place to cook or eat. So they buy their children the cheapest street food, which is usually either sweet or deep fried. Kedai Balitaku, which usually goes by the name KeBal, aims to become a chain of street carts selling low-priced healthy food to children.
Read More

In ‘Food Deserts,’ Oases of Nutrition

By Tina Rosenberg

Thatcher Cook for Mercy Corps

School girls lined up to purchase after-school snacks at one of the Kedai Balitaku food carts in Jakarta, which serve healthy food to children.

Poor urban neighborhoods in America are often food deserts — places where it is difficult to find fresh food. There are few grocery stores; people may do all their shopping at bodegas, where the only available produce and meat are canned peaches and Spam. If they want fruits and vegetables and chicken and fish, they have to take a bus to a grocery store. The lack of fresh food creates a vicious cycle; children grow up never seeing it or acquiring a taste for it. It is one reason that the poor are likelier to be obese than the rich.
Read More

Publishers As Partners In Literacy

By David Bornstein

This week, I reported on the First Book Marketplace, which sells new books at steep discounts to schools and reading programs serving low-income children. Based on sales growth, First Book, which is a nonprofit, anticipates that the marketplace will be financially self-sustaining within a few years. It’s hard to find fault with a social-purpose business that makes quality books more affordable for underprivileged children. But, surprisingly, many readers responded to the idea by suggesting that the problem of book access can be adequately addressed through rummage sales, thrift shops, used book outlets and libraries. This reflects a misunderstanding of the problem, which I’d like to clarify.

Read More

A Book In Every Home, And Then Some

By David Bornstein

When we imagine people without books, we think of villagers in places like Afghanistan. But many families in the United States have no children’s books at home. In some of the poorest areas of the country, it’s hard to find books for sale. A study (pdf) of low-income neighborhoods in Philadelphia, for example, found a ratio of one book for sale for every 300 children. Tens of millions of poor Americans can’t afford to buy books at all.

At Fixes, we like to highlight creative ways that markets can be harnessed to extend access to vital services like electricity, credit, or water. Today, I’m focusing on a nonprofit organization called First Book, which is spearheading a new market mechanism that is delivering millions of new, high quality books to low-income children through thousands of nonprofit organizations and Title I schools.

Read More

To Survive Famine, Will Work For Insurance

By Tina Rosenberg

How much would it cost to prevent a famine? We don’t know exactly, but one answer is surely this: Much less than it would cost to save lives after famine hits. The relief group Oxfam estimates that emergency relief in famines costs seven times as much as preventing the disaster to begin with.

In Ethiopia — long a country of recurring famines — cycles of drought and flash flooding are worsening and grain harvests are falling. More than 13 million people in Ethiopia are kept alive by sacks of grain and cans of cooking oil from the United Nations World Food Program. And as the W.F.P. and others have warned, climate change is likely to make things even worse.

Read More

Doing More Than Praying For Rain

By Tina Rosenberg

In the United States, insurance against extreme weather is seen as so important that Washington subsidizes it highly and requires it for farmers who want other government benefits. If American farmers need weather insurance, African peasant farmers need it even more. But the vast majority of African peasant farmers have no opportunity to insure their crops.

Virtually all small farmers in Africa depend on rain for irrigation. Most have no safety net — a farmer planting an acre of corn twice a year can find her family nearly destitute if the crop fails because of drought early in the planting season, or too much rain later on. She will have invested everything she has in seeds and fertilizer. There will be nothing left for the next planting season.

Read More

Fostering A Team Approach To Drug Cures

By David Bornstein

Earlier this week, I reported on the Myelin Repair Foundation (M.R.F.), an organization that is working to develop a novel treatment for multiple sclerosis, a degenerative disease that currently has no cure. Over the past four decades, despite extraordinary advances in bioscience, cures for many chronic diseases have remained elusive. As Norman from New York City (17) noted, the survival rates for many cancers have not changed much since the launch of the nation’s war on cancer during the Nixon administration: “The death rate has only declined by 3.3 percent or less in colon cancer, breast cancer, prostate cancer, and leukemia.” In response, groups like the M.R.F. have begun exploring new models to accelerate research and hasten the development of new treatments for disease.

Read More

Helping New Drugs Out Of Research’s “Valley of Death”

By David Bornstein

Consider two numbers: 800,000 and 21.

The first is the number of medical research papers that were published in 2008. The second is the number of new drugs that were approved by the Food and Drug Administration last year.

That’s an ocean of research producing treatments by the drop. Indeed, in recent decades, one of the most sobering realities in the field of biomedical research has been the fact that, despite significant increases in funding — as well as extraordinary advances in things like genomics, computerized molecular modeling, and drug screening and synthesization — the number of new treatments for illnesses that make it to market each year has flatlined (pdf) at historically low levels.

Read More

Speaking Up For Patient Safety, And Survival

By Tina Rosenberg

On Tuesday, I wrote about a new technological system that might help hospitals to accurately track whether health care workers are washing their hands, and remind them to do so in real time. The reason hospitals might want to spend the money to install such an expensive fix is that so far, very few hospitals have been able to get their hand-washing rates above 50 percent.

Health care workers’ failure to clean their hands is the most important cause of hospital-based infections, which are the fourth-leading cause of death in America and cost our health care system some $40 billion a year.

Read More

Better Hand-Washing Through Technology

By Tina Rosenberg

Why can’t hospitals get health care workers to wash their hands?

Hospitals in the United States enjoy access to running water. Virtually all of them have alcohol-rub dispensers, hundreds of them, in the hallways. Using one takes a few seconds. Yet health care workers fail to wash hands a good percentage of the times they should. Doctors are particularly bad.

A health care worker’s hands are the main route infections take to move from one patient to another. One recent study of several intensive care units — where the patients most vulnerable to infection reside — showed that hands were washed on only one quarter of the necessary occasions.

Read More

When Math Makes Sense (To Everyone)

By David Bornstein

In response to Tuesday’s column about Jump Math, an approach to math education that is showing impressive results in schools in Canada and England, a great many readers wrote in to share stories of how they or their children have struggled with math (or, in some cases, were almost traumatized by it). “I failed math as a school-aged boy,” wrote Rob Blake, from New York. “I avoided math like one of the 10 plagues.”

Many asked how they could get more information about Jump. Parents or educators can get teaching guides and lesson plans free from Jump Math’s Web site (registration is required). Workbooks are available for sale; proceeds support the organization, which is a nonprofit. John Mighton, a mathematician who is the founder of Jump, has also written a book called “The End of Ignorance,” which details the program’s philosophy and explains how it contrasts with current teaching approaches.

Read More

A Better Way To Teach Math

By David Bornstein


Is it possible to eliminate the bell curve in math class?

Imagine if someone at a dinner party casually announced, “I’m illiterate.” It would never happen, of course; the shame would be too great. But it’s not unusual to hear a successful adult say, “I can’t do math.” That’s because we think of math ability as something we’re born with, as if there’s a “math gene” that you either inherit or you don’t.

School experiences appear to bear this out. In every math class I’ve taken, there have been slow kids, average kids and whiz kids. It never occurred to me that this hierarchy might be avoidable. No doubt, math comes more easily to some people than to others. But the question is: Can we improve the methods we use to teach math in schools — so that everyone develops proficiency?

Read More

Ethical Businesses With A Better Bottom Line

By Tina Rosenberg

On Tuesday, I wrote about B Corps, or benefit corporations.  These are companies that have changed their bylaws to take into account the impact of their decisions on the environment, community and employees, as well as profits.  To become a B Corp, a company must also get a passing score on an assessment of its business practices administered by a nonprofit group called B Lab.  About 400 companies have become B Corps, and the idea is spreading fast.

Readers had a lot of praise for the idea of the triple bottom line: people, planet and profits.   But many businesses are wary.   It’s great to be socially responsible — but not if it means you won’t be around next year.  Businesses want to know if they can become B Corps without sacrificing their more traditional bottom line.

Read More

Who Else is Joining the Club?

Do you know of others who are using Join the Club solutions?   How about people who should be thinking about it?   Do you have an opinion about the book?

Let’s talk about it!

 

A Scorecard for Companies With a Conscience

By Tina Rosenberg

Eleven years ago, the Vermont-based ice cream-maker Ben and Jerry’s found itself in a position other companies might have found enviable. Several firms were bidding to buy it. The top bid was from the Dutch conglomerate Unilever.

But Ben Cohen and Jerry Greenfield didn’t want to sell to Unilever. They had built the company with the mission of serving what has come to be known as the “triple bottom line” — profits, people and planet. The company offered voter registration along with its ice cream, paid employees living wages and good benefits, donated 7.5 percent of its profits to charity, and bought Brazil nuts from a cooperative of indigenous Amazon farmers and brownies from a bakery famous for hiring people fresh out of prison. Ben and Jerry worried that a Unilever-owned company would quickly become focused purely on profit.

Read More

The Power of the Playground

By David Bornstein

Ask a young child, “How was school today?” and you’re likely to hear about recess. My son is 7 years old, and like many children his age, recess is the emotional core of his school day. Whether he comes home light- or heavy-hearted depends on what happened during play time. This is common. Researchers say that one of the best predictors of whether kids feel happy in school is whether they feel comfortable and competent during recess.

This is not exactly a groundbreaking insight. Philosophers and child development experts have been trumpeting the importance of play for centuries. Piaget said that children discover the world through play. Friedrich Froebel, who opened the first kindergarten in 1837, called play “deeply significant.” And Plato believed that children had to grow up in an atmosphere of play to become virtuous citizens.

Read More

Hard Times for Recess

By David Bornstein

More than 150 years ago, Charles Dickens published “Hard Times,” a novel centered around the students of an English schoolmaster named Thomas Gradgrind, who had no use for play or any sort of imaginative pursuit. For Gradgrind, if something did not demonstrably add to the productive capacity of the nation and could not be justified with facts and statistics, it had no place in a child’s education.

Dickens invented Gradgrind (and introduced him in a chapter entitled “Murdering the Innocents”) to dramatize what he saw as the soullessness of utilitarianism, a school of thought prevalent in England during the Industrial Revolution that emphasized rational pursuits and quantitative measures over all else.

Read More

On the Web, A Revolution in Giving

By Tina Rosenberg

On Tuesday, I wrote about how crowdsourcing Web sites are allowing people to contribute knowledge and ideas to bring about social change. But virtually every social change organization will say that what it needs most is money. Giving to charity did not start with the Internet. But crowdfunding offers donors new ways to get more involvement and impact for their charity dollar.

In traditional giving, one of the things big donors can buy with their big checks is a sense of partnership with the organization — they can choose or even invent a project to finance, meet the staff, receive private briefings and get asked for their advice (sincerely or not). They know their largesse matters.

Read More

Crowdsourcing a Better World

A friend who is a reader of Fixes recently told me she was often frustrated by the column. She doesn’t run a nongovernmental organization or design products to help bottom-of-the-pyramid consumers get drinkable water. She isn’t going to take six months to volunteer in Nepal. She’s a New Yorker with a job — what can she do, she asked, to contribute to changing the world?

There’s always writing a check, of course. Money is what every project needs most. Beyond that, however, there is a relatively new way for individuals to participate in social change through crowdsourcing, which is a fix in itself.

Read More

Microfinance Under Fire

By David Bornstein

Munir Uz Zaman/Agence France-Presse — Getty Images

Muhammad Yunus, center, outside the high court building in Dhaka, Bangladesh, on March 6 where he contested the government’s decision to remove him from his post in Grameen Bank.

At Fixes, our focus is typically on implementing new or underutilized ideas to help those in need. But sometimes it’s just as important to protect institutions that are already working well. Which is why I’m writing today about the Grameen Bank, the Bangladeshi organization that won the 2006 Nobel Peace Prize, along with its founder Muhammad Yunus, for its work extending microloans to some of the world’s poorest, and has been crucial in global efforts to lift millions of people out of poverty.
Read More

A Pay-for-Performance Evolution

By Tina Rosenberg

Every discussion about foreign aid is a heated discussion. Readers of Tuesday’s column on a new idea for foreign aid — paying for outcomes instead of providing money in advance — had plenty of suggestions about how to fix foreign aid (or why to abandon it). But before we get to them, we should make sure we know what we’re talking about when we say “foreign aid.” “It would be better if the citizens understood that ‘foreign aid’ is a misnomer,” wrote Millie Bea of Washington.
Read More

How to Protect Foreign Aid? Improve It

By Tina Rosenberg

A Bloomberg National Poll says that more than 7 in 10 Americans think that Congress can find major savings in the federal budget by slashing foreign aid.  It’s a new poll, but this is old news.

Americans have always vastly overestimated how much we spend on foreign aid.   A 2010 survey asked Americans what percentage of the federal budget went to foreign aid.  The median response was 25 percent.  When asked what percentage would be appropriate, the answer was 10 percent.  Polls going back at least a decade show similar responses. In fact, foreign aid accounts for less than 1 percent of the federal budget.
Read More

The Power of Partnerships

By David Bornstein

Some problems are simply too complex to solve with any single approach. Consider the fact that in the United States, a million students drop out of high school each year. To begin to turn back that trend, we need to work on several fronts — assist vulnerable families when children are infants, improve classrooms from preschool through high school, provide after-school supports and college access assistance, tackle the issue of summer-learning loss and get much smarter about addressing students’ social and emotional needs at every stage. In the words of Clay Shirky: “Nothing will work, but everything might.”
Read More

Coming Together to Give Schools a Boost

By David Bornstein

We only have to consider some of the nation’s greatest achievements to appreciate what’s possible when we coordinate efforts rationally. At its peak, for example, the Apollo program, which put a man on the moon, involved 400,000 people and 20,000 companies and academic organizations. The Manhattan Project, which produced the first atomic bomb, coordinated the work of 130,000 scientists, engineers and others. The Los Angeles Olympic Games were successful because of unprecedented cooperation among civic groups, government agencies and businesses.

Read more…

The Health Coach You Know

By Tina Rosenberg

Ozier Muhammad/The New York Times

Joyce Strickland, who works for the Center for Comprehensive Care, draws on her own experience with illness to help patients with their treatment.

On Tuesday, I wrote about how a health worker named Reynaldo Rodriguez worked with a patient, Joe McManus, to help him stick to his treatment plan to control his AIDS and Hepatitis C. Most of us don’t have the multiple serious illnesses and problems that  McManus does, but a lot of us still share his basic challenge: how do we get ourselves to live more healthfully?    We might need to eat better, quit smoking or drinking or exercise more.  Instead of thinking of it as treatment adherence, we might call it keeping our New Year’s resolutions.
Read More

A Housecall to Help With Doctor’s Orders

By Tina Rosenberg

Doctors are very good at telling us what to do — but we are very poor at doing it. In fact, the health problems of millions of Americans are directly related to our failure to follow doctors’ orders.

Doctors tell us to take our pills, exercise, go get that C.T. scan, stop smoking, change our diets, cut out salt, quit drinking, monitor our blood sugar.  We know we should do it, but we very often don’t.  About three-quarters of patients do not keep appointments for follow-up care.  In one study of diabetes patients, only 7 percent were compliant enough with their treatment plans to control the disease.  Even people at grave and immediate risk do not always take their medicines:  a quarter of kidney transplant patients in one study did not take their medicines correctly, putting them at risk for organ rejection. Among elderly patients with congestive heart failure, 15 percent of repeat hospitalizations were linked to failure to take prescribed medicines.  And compliance with exercise and diet programs is even worse.   Poor compliance is a major reason that sick people don’t get better, and that our health care costs are so high.
Read More

A Network of Support

By David Bornstein

In my column this week I examined the work of an organization called Youth Villages, which offers intensive in-home services to help children in the foster care system return to their families, or extended families, wherever it is possible to do so safely. My point was to highlight the fact that this approach, which is vastly underutilized and underfunded, is proving to be superior to the current practices in the child welfare system. It’s now common for youth to remain in foster care or residential treatment for years. When they age out of these systems, many are unable to live successfully as adults.
Read More

Revolution U:  What Egypt Learned from the Students who Overthrew Milosevic

Revolution U: What Egypt Learned from the Students who Overthrew Milosevic

Originally published here, February 16, 2011
Tina Rosenberg

Early in 2008, workers at a government-owned textile factory in the Egyptian mill town of El-Mahalla el-Kubra announced that they were going on strike on the first Sunday in April to protest high food prices and low wages. They caught the attention of a group of tech-savvy young people an hour’s drive to the south in the capital city of Cairo, who started a Facebook group to organize protests and strikes on April 6 throughout Egypt in solidarity with the mill workers. To their shock, the page quickly acquired some 70,000 followers.
Read More

About the Book

About the Book

About the Book

Join the Club is the story of an extraordinarily powerful kind of social change. It has led teens in America to rebel against cigarettes and teens in Africa to protect themselves from AIDS. It has brought worshippers into a closer relationship with God. It has led millions of people to quit drinking and drugs. It has organized a passive and fearful citizenry subjugated by a dictator into the nonviolent army that overthrew him. Through stories drawn from the affluent suburbs of Chicago to the impoverished shanties of rural India, this is a book that will not only revolutionize the way you look at the world, but give you the power to change it.

Read more

A Families-First Approach to Foster Care

By David Bornstein

Sonja Luecke

Family Intervention Specialist Leontyne Scott, second from right, works with a young man and his family. Youth Villages counselors do much of their work in the kitchens and living rooms of families they assist.

It’s difficult to change systems even when they are widely acknowledged to be broken. That’s the situation facing the nation’s foster care system. According to the government’s most recent estimate, there were roughly 424,000 young people in foster care as of Sept. 30, 2009. Each year, about 30,000 of them turn 18 (or 21 in some states) and “age out” of foster care. What happens to them?
Read More

What Makes Community Health Care Work?

By Tina Rosenberg

Ashim Hajra

An eye examination by a Jamkhed community health worker.

In response to Tuesday’s column about two programs in India that train relatively uneducated women as their villages’ health workers, readers provided an avalanche of information about other community health worker programs around the world. Gregory Ortiz from London (95) wrote about Operation ASHA, which has semi-literate counselors treating tuberculosis in slums in India and Cambodia.  In thefield from Alaska (109) wrote about para-dentists in rural Alaska.    Marianne Loewe (121) from Santa Ana, Calif., commented on her organization, Concern America, which works with health promoters in Colombia and Central America.
Read More

Going to Extremes: Why Muslim Fundamentalists May Be Our Best Hope for Stopping Terror

Originally published here March/April 2011
Tina Rosenberg

courtesy of STREET

In 1996, Richard Reid, a petty criminal recently released from prison, found his way to an unassuming mosque in the rough-edged south London neighborhood of Brixton. The majority of worshippers were converts to Islam: some of them ex-convicts who had taken up the faith in prison, some immigrants. Most of the women wore the full niqab and abaya, showing only their eyes in accordance with the mosque’s strictly conservative bent.

Read More

Villages Without Doctors

By Tina Rosenberg

For the next few weeks, I’ll be writing about an idea that can make people healthier while bringing down health care costs, both in poor countries and in the United States.

The strategy is to move beyond doctors — to take the work of health care and shift down from doctors and nurses to lay people, peers and family.  In the United States and other wealthy countries, lay people can fill in the gaps in left by doctors’ care.  In poor countries, people with no or little formal medical training are successfully substituting for doctors and nurses.
Read More

Making the Text-to-Mom Connection

By David Bornstein

Earlier this week, I wrote about text4baby, a free service that sends text messages to pregnant women, or new mothers, to provide them with useful health tips. What struck me as most noteworthy about this program was how hundreds of different types of organizations — for-profit health care providers, nonprofit community groups, wireless carriers, government agencies, and many others — had collaborated to make it all work. Text4baby seemed to shed light on the question: How do you get a country — with all its diverse institutional strengths — to work as a team?
Read More

Mothers-to-Be Are Getting the Message

By David Bornstein

Meredith Inman

Text4baby reaches women by many means, including billboards like this one in Martinsville, Va.

We’re used to hearing about public initiatives that get mired in politics or entangled in bureaucracy, but we rarely hear about programs that exceed expectations. So here’s one: last week marked the one-year anniversary of a program called text4baby, a service that sends free text messages to women who are pregnant or whose babies are less than a year old, providing them with information, and reminders, to improve their health and the health of their babies.
Read More

How to Grow a Social Business

By Tina Rosenberg

In Tuesday’s column, “When Microcredit Won’t Do,” I wrote about microconsignment, a way for village entrepreneurs to sell innovative and important products for which there is no established market — such as solar lamps, water purifiers, stoves and reading glasses — without having to take on debt.  Instead, village women are given the products and the training to sell them.  Once they make the sale, they repay the supplier and keep a portion of the proceeds.  Done right, microconsignment provides new businesses for village women — and helps make life healthier and more prosperous for her neighbors.
Read More

When Microcredit Won’t Do

By Tina Rosenberg

Darby Films

Greg Van Kirk teaches an entrepreneur how to give an eye exam.

If you asked poverty experts to name the single most significant new concept in the field in the last few decades, chances are they would say microcredit.  Microcredit is the lending of very small amounts of money to very poor people to help them invest in things that have the potential to bring income later on — a loan of $50 to buy a sewing machine to make clothes, for instance, or piglets to raise and sell.  It reaches nearly 100 million clients in more than 100 countries.
Read More

Beyond the Business Suit

By David Bornstein

Earlier this week, I wrote about Year Up, an organization that is unusually successful at preparing young adults from disadvantaged backgrounds for jobs in big companies like banks, investment houses, health care providers and technology firms. What became clear to me while researching the story was that workforce development no longer means giving people job skills; it means giving them the ability to navigate a career in a professional environment. This isn’t knowledge you’re born with. You pick it up from family and friends and, if you’re lucky, from mentors. Oddly, for something so important, it receives little emphasis in schools and colleges; many job training programs gloss over it.
Read More

Training Youths in the Ways of the Workplace

By David Bornstein

The most frustrating economic news of 2010 wasn’t that the recession had worsened — it was that things had improved markedly for corporations, but not for the labor force. Even Alan Greenspan expressed concern that the U.S. is evincing “fundamentally two separate types of economy” — one in which big companies and high earners thrive, the other in which millions struggle to find jobs and make ends meet. One group that has been particularly hard hit by the recession is youth. Among workers aged 16 to 24, the unemployment rate is almost 20 percent. For young Latinos, it’s over 24 percent, and for young African Americans, it’s over 32 percent. Some 4.4 million youths are currently unemployed.
Read More

A Light in India

By David Bornstein

© Harikrishna Katragadda/Greenpeace

Students in the village of Tahipur in Bihar used kerosene lanterns for studying.

When we hear the word innovation, we often think of new technologies or silver bullet solutions — like hydrogen fuel cells or a cure for cancer. To be sure, breakthroughs are vital: antibiotics and vaccines, for example, transformed global health. But as we’ve argued in Fixes, some of the greatest advances come from taking old ideas or technologies and making them accessible to millions of people who are undeserved.
Read More

Removing the Roadblocks to Rehabilitation

By Tina Rosenberg

Jim Wilson/The New York Times

The Delancey Street Foundation’s buildings along the Embarcadero in San Francisco.

What works and what doesn’t work to solve a social problem is often no mystery.  The mystery is why we so often persist in doing what doesn’t work.  The topic of Tuesday’s column — prisoner re-entry into the community — offers myriad examples.   One is the practice of dropping people getting out of jail or prison right back into the neighborhoods where they got in trouble in the first place.  Intuition tells us that this is a bad idea: the old street corners and the old friends seem like a recipe for the old troubles.  Research on this idea is rare and hard to do — it’s tough to get around the problem that the person who chooses not to go home may have other qualities that make him successful.
Read More

For Ex-Prisoners, a Haven Away From the Streets

By Tina Rosenberg

Hiroko Masuike for The New York Times

The Fortune Academy in West Harlem.

This year, the United States will release nearly three-quarters of a million people from prison, a record high.   Nationally, 2.3 million people are in prison in the United States, and 95 percent of them will, at some point, get out and go home.

 

Society has a strong interest in keeping them home — in helping them to become law-abiding citizens instead of falling back into their old ways and returning to prison.  But American programs for newly released prisoners echo the typical follies of our criminal justice system:  our politicians usually believe that voters only want the emotional satisfactions of meting out maximum punishment, even if these policies lead to even more crime.
Read More

Illuminating Thoughts on Power

By David Bornstein

One of the pleasures of writing a column about creative problem solving is that readers typically write back with practical, rather than ideological, critiques as well as suggestions for other solutions to highlight. The comments from this week’s Fixes column on Husk Power Systems were enlightening — and provided rich fodder for future columns.
Read More

To Beat Back Poverty, Pay the Poor

By Tina Rosenberg

Bruno Domingos/Reuters

An apartment building in front of the Rocinha shantytown in Rio de Janeiro.

The city of Rio de Janeiro is infamous for the fact that one can look out from a precarious shack on a hill in a miserable favela and see practically into the window of a luxury high-rise condominium.  Parts of Brazil look like southern California.  Parts of it look like Haiti.  Many countries display great wealth side by side with great poverty.  But until recently, Brazil was the most unequal country in the world.
Read More