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USAID Administrator: Food Security a 'Grand' But 'Achievable' Goal

Fri, 18 May 2012 18:17:00 EDT

President Obama outlined Friday a private-public partnership to work on global poverty issues ahead of the Group of Eight summit in Camp David this weekend. Ray Suarez and USAID Administrator Rajiv Shah discuss the initiative to lift millions out of poverty and hunger through farming partnerships.

MARGARET WARNER: And we turn to a new plan to help hunger in sub-Saharan Africa.

Suarez has that story.

RAY SUAREZ: Food security, getting enough food to the world's poorest people, is on the agenda this weekend as President Obama meets with other world leaders at the G8 summit in Camp David.

Across the African continent, food shortages drive instability, refugee flows, and armed conflict in places like Somalia, Kenya, Darfur, South Sudan and Ethiopia, among others.

Today, President Obama outlined a private-public partnership to work on global poverty issues and discussed plans to include four African leaders at the G8 summit. The president called lifting millions out of poverty and hunger through farming a moral obligation for both governments and businesses.

PRESIDENT BARACK OBAMA: Government cannot and shouldn't do this alone. This has to be all hands on deck.

RAY SUAREZ: The head of this country's foreign aid agency, Dr. Rajiv Shah, unveiled the Agency for International Development's program to bring U.S. agribusiness and Africans together to improve food productivity.

I talked with USAID Administrator Dr. Shah this afternoon.

Dr. Shah, welcome back to the program.

DR. RAJIV SHAH, administrator, United States Agency for International Development: Thank you. Thanks, Ray, for having me.

RAY SUAREZ: We have already briefly described the overall project and its objectives. But maybe you could talk a little bit more about how we're going to accomplish that very grand goal, lifting 50 million people out of poverty in 10 years.

DR. RAJIV SHAH: Well, it's actually -- it's a grand goal, but it's an achievable goal.

And we're going to accomplish it by bringing significant public sector investment, maintaining the commitments that President Obama and others have made over the last few years to reinvest in African agriculture and African agricultural institutions.

And we're going to achieve that goal by bringing a whole host of exciting new partners to the table, private companies in Africa that are providing seeds to small-scale farmers, companies from India or Europe that have something to offer, improving small-scale agriculture in Africa, and American firms, firms we would recognize easily that are now committing themselves to make real businesslike investments for the purpose of making sure that a smallholder farmer, often a women, in sub-Saharan Africa can produce enough food to feed herself, feed her family, go to market, extract more value from market and move her whole community out of poverty.

RAY SUAREZ: Right now, Africa is dealing with creeping deserts, less reliable rain, hotter and dryer climates. Are you sort of pushing a rock uphill with a project that leans so heavily on agriculture?

DR. RAJIV SHAH: Well, there's another part of this that is downhill, pushing the rock downhill.

And that is that Africa has 60 percent of the world's remaining unused arable land. And in a world that needs to produce enough food, double food production in order to feed nine billion people by 2040, that land has got to come into production.

Africa has some of the lowest yields on the planet, crop by crop. And we know and we have seen in western Kenya you can double or triple yields relatively quickly using all local solution solutions. And then what happens is millions of people don't need food aid during a famine or a drought. So this is a solvable problem. And there is as much of a downhill story as there is an uphill one.

RAY SUAREZ: The Saudis and the Chinese seem to be well aware of the agricultural potential of Africa. Aren't they buying up a lot of land to produce food for their own people?

DR. RAJIV SHAH: Well, they are. That's why today, and what's happening in so novel in terms of making sure that we have private sector companies involved in making investments to improve African agriculture and poverty outcomes, but also that those companies are agreeing to make investments under some common principles of transparency and responsibility.

Let's shine sunlight on what's happening so that everyone can see transparently where are the investments going? Who are they benefiting? How are they making sure that a young girl growing up in a rural household is getting access to nutrition so she can go to school and move on with her life in a productive way?

And there is a lot of investment going in, but unfortunately not enough of it falls under these principles of transparency. And through this new initiative, more than 45 companies are making more than $3 billion of investment commitments and doing so under these principles of transparency and responsibility for the first time.

RAY SUAREZ: You are going to roll out in Ghana, Tanzania and Ethiopia. There are more than four dozen countries in Africa. How did they get to the front of the line? Were there things they had to do first to be ready?

DR. RAJIV SHAH: Well, absolutely.

We talked to hundreds of private sector partners. And we found that until countries really, seriously reformed access to land tenure for a small-scale farmer, so that women farmers can actually have title to their land and go to a bank and get a loan, or until they reformed the way they regulate their seed sector, so that small seed companies can start selling improved crop varieties to farmers and help them overcome drought or pest or disease, those are the types of reforms that are required for these companies to make investments.

And we have started in those countries that are most eager to make those reforms. And they have come to Washington with real commitments. They have actually come with reform commitments, where there are dates set on when those reforms will take effect over the next 18 months.

RAY SUAREZ: I want to look a little closer at Ethiopia, because unlike Ghana and Tanzania, the Democracy Index run by the Economist Intelligence Unit rates it as an authoritarian regime, rates it 118th among the 167 countries on the Earth in terms of freedom and transparency in government.

It had a tough time getting born, modern Ethiopia. And there are human rights charges against the president. Why are they getting the pilot program?

DR. RAJIV SHAH: Well, you know, every year, the world rushes in with hundreds of millions of dollars of food aid to save and help Ethiopians who are hungry.

And during last year's drought, that number went to more than $1 billion. And the reality is, you know, we just absolutely have to keep pushing for more transparency, more open governance, for democracy to take root, because we know that democracy and development go hand-in-hand.

But we also have to make sure that we are insisting upon improved policies so that companies can invest, so that farmers can produce more food, and so that we can banish this image of starving Ethiopian children that, you know, does, in fact, call upon our moral values and forces us to react.

By doing the work this way, we will help Ethiopia feed itself. We will help those children over time move out of poverty, and we're engaging in a deep and meaningful dialogue to promote democracy, as we do in so many other parts of the world.

RAY SUAREZ: When you look at Africa, millions of people are working really hard every day to feed themselves, but there's so much to be done. There's bad roads for shipping crops regionally, bad facilities for holding on to food so it doesn't spoil by the time somebody gets a chance to eat it, bad ship facilities for getting cash crops, things that can be sold internationally, out of the country. Ethiopia doesn't even have a seaport anymore.

How do you figure out what to do first?

DR. RAJIV SHAH: Well, this is a great question, because the reality is we need a lot of these things to happen simultaneously in order to unlock the value and potential of African agriculture, so it can feed itself and feed the world.

And the reality is, that's happening. Now we have an Ethiopian commodity exchange that is helping to create a market alongside DuPont that today is making a commitment to invest real resources to reach 50,000 small-scale Ethiopian farmers with improved seed varieties that can help them and soil mapping data and other things that can help them improve their production.

In southern Tanzania, we are seeing Yara, a fertilizer company, invest in redoing the port, the African Development Bank invest in building road infrastructure, partners like USAID investing in helping farmers upgrade their skills, and companies like Tanseed, a small Tanzanian seed company, committing $11 million to help get improved seed varieties to small-scale farmers, and to do it in often small packets, because if you are farming half an acre of land or an acre of land, you don't feed a big bag of seed. You need a small packet.

And little innovations like that can go a long way at transforming the face of hunger and poverty.

RAY SUAREZ: Dr. Shah, thanks for talking to us.

DR. RAJIV SHAH: Thank you.

Combating Hardship in Rural Thailand

Thu, 17 May 2012 18:39:00 EDT

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From Thailand, special correspondent Fred de Sam Lazaro reports on one social entrepreneur's efforts to combat hardships and instill a new way of thinking in the rural regions of the relatively prosperous country.

JEFFREY BROWN: Next tonight, narrowing the gap between urban and rural dwellers that exists even in a relatively prosperous country such as Thailand.

Special correspondent Fred de Sam Lazaro reports on one social entrepreneur's project in that Southeast Asian nation.

A version of this segment aired on the PBS program "Religion and Ethics Newsweekly."

FRED DE SAM LAZARO: It looks more like a theme park than a school. And it's not just its location in one of Thailand's most impoverished regions that's unusual. Buildings are made of bamboo, including a geodesic dome, just one way Mechai Viravaidya getting people to think differently.

MECHAI VIRAVAIDYA, Thailand: Well, just to show that you can do things people don't normally think can be done, such as getting underprivileged kids to be at the top of the scale of many, many things, of being good, being decent.

FRED DE SAM LAZARO: The Mechai Pattana School is the cornerstone of an idea to attack rural poverty and stereotypes and to instill a new kind of learning.

MECHAI VIRAVAIDYA: This is our sex education wheel.

FRED DE SAM LAZARO: The "Wheel of Fortune" game teaches about various sexually transmitted diseases.

MECHAI VIRAVAIDYA: Green is a safe color, of course. Aha! Oh, aha! HIV, oh boy, you just missed that. And they have a good laugh, and then because HIV is explained up there. . .

FRED DE SAM LAZARO: Mechai has long relied on good laughs to explain HIV and sex education in this conservative Southeast Asian nation.

Born to physician parents, his mother from Scotland, his father from a prominent Thai family, Mechai was trained as an economist. But he became a TV personality who spearheaded family planning campaigns in the '70s and, two decades later, condom use to prevent HIV.

I first interviewed him in 1998.

MECHAI VIRAVAIDYA: We said, look, one must not be embarrassed by the condom. It's just from a rubber tree, like a tennis ball. If you're embarrassed by a condom, you must be more embarrassed by the tennis ball. There's more rubber in it.

FRED DE SAM LAZARO: Mechai is credited with bringing down Thailand's soaring HIV infection rate and its high birth rate, work that won him numerous international awards, including the $1 million dollar Gates Foundation Prize for Global Health.

Dr. Malcolm Potts, former head of the International Planned Parenthood Federation, says it changed the future of Thailand.

DR. MALCOLM POTTS, former head, International Planned Parenthood Federation: In 1960, Thailand and the Philippines had about the same population, about 60 million people, 50 million people. Today, the Philippines has 94 million people, and there's a lot of poverty. Thailand has 1.8 children per family. It's got about 68 million people, and it's making progress.

FRED DE SAM LAZARO: Potts was an early collaborator with Mechai. He says population stability was an economic stepping stone.

DR. MALCOLM POTTS: I think it's a seamless evolution. Mechai, at least in the past, used to talk about fertility-led development.

FRED DE SAM LAZARO: Thailand, now considered a middle-income country, faces a different crisis that Mechai is attacking: a growing economic gap between its rural and urban areas that forces young people to leave the farms to find work.

On a beach resort once owned by Mechai's family -- it's now run by a non-profit group he founded -- is a garden of so-called intensive agriculture. He wants to develop appropriate sustainable technology to increase incomes in farm families.

MECHAI VIRAVAIDYA: This is the new style condom. This is the poverty eradication condom.

(LAUGHTER)

FRED DE SAM LAZARO: The unusual metaphor aside, he says these recycled bags of potting soil can grow produce, in this case cantaloupes, with a minimum of water and space and maximum profit.

MECHAI VIRAVAIDYA: You'd grow it four times a year, so that's 34,000 baht. That's just under a thousand dollars for this much space, nearly as good as marijuana. Might be even better. Don't have to share with the police, either.

FRED DE SAM LAZARO: All joking aside, he says other Thai staples, mushrooms, limes, poultry and hydroponic produce, can easily be grown in rural enterprises, like those he's helped set up in Buriram Province, about four hours from Bangkok.

He's worked here for two decades, introducing his crop ideas. Earlier in his career, he helped bring factories to the region. They now operate independently.

MECHAI VIRAVAIDYA: You have a factory in the middle of nowhere here.

FRED DE SAM LAZARO: This shoe factory was started with international grants. It now provides work for 140 to 200 people, producing mostly for the multinational Bata shoe company.

MECHAI VIRAVAIDYA: We helped, from Canadian money again, to provide a loan for them to establish a factory building, and then helped to get Bata to come in, rented the machinery and then bought the machinery, and they've been on their own for about 15 years.

FRED DE SAM LAZARO: A short distance away are buildings once used to train people to raise livestock. Now they are factories, making brassieres in this building, ice skates in the next.

MECHAI VIRAVAIDYA: How could you imagine an old chicken pen and an old pig pen making this stuff, or brassieres?

FRED DE SAM LAZARO: Was it really a tough sell at first?

MECHAI VIRAVAIDYA: Oh, yes, took seven visits. They did it out of pity at first. And then they realized that it worked. And when the first -- when we bring someone new down, they can't quite fathom it, how can it be done, because they have been so used to the perception that you do everything like this in Bangkok, in the city.

FRED DE SAM LAZARO: The factories provide livable, if not lucrative, wages and social benefits. But to truly transform rural communities, Mechai says will take new approaches to education.

And that's where the bamboo school comes in. It is now 3 years old, serving grades seven through 10. Funds to build it came from profits from his resort, the Gates prize money, and corporate donations. Longer term, the school is developing its own vegetable farm, a key part of its business strategy.

So when this is up and running and flourishing, the cantaloupes and the limes will be paying the teacher salaries here?

MECHAI VIRAVAIDYA: Yes. Amongst other things, really, yes.

FRED DE SAM LAZARO: The motto here is, the more you give, the more you get. Aside from academics, every student and family face strict work requirements.

MECHAI VIRAVAIDYA: The parents do community service, and the kids do community service, and for every lunch time or meal time you have to do one hour's community service, so that payment is in providing help to other people, plus their school fees.

FRED DE SAM LAZARO: As part of their service, these students were preparing lesson plans to teach younger children in a nearby government school. It's part of their training in leadership and critical thinking, and a departure from the rote learning standard in most Thai public schools.

RUTHAICHANOK JUNPENG, student (through translator): The teachers are here to teach us, but they're also like friends, like an older friend that you can go to for advice, not just about what you're learning.

PIMPAKAIN SIRI, student (through translator): My parents are rice farmers, and I expect my future to be quite different, because I want to become a doctor, and I believe I can do that. I've learned new ways to help my parents, who are used to doing agriculture the traditional ways. And I can help raise their income.

FRED DE SAM LAZARO: And because students at Mechai's school regularly volunteer, they feel connected to their rural communities, says teacher Nantina Saninchai. She predicts two-thirds of them will create or find jobs here.

NANTINA SANINCHAI, teacher (through translator): So a number will stay here. They have computers, et cetera, similar to what they would in the city.

FRED DE SAM LAZARO: Ideas from Mechai's school are catching on with various backyard enterprises. On weekends in the village of Banong Takem, children collect litter in exchange for spending time online at a community center or in a toy and book library.

Parents prepare food and hand out treats. The village chief, Chamleung Panrin, says one reason this community thrives is that parents are around for their children.

CHAMLEUNG PANRIN, village chief (through translator): Eight years ago, migration was rampant. Everybody would leave, and you only had children being brought up by the grandparents. Now it has very greatly improved.

MECHAI VIRAVAIDYA: The only road out of poverty is through business enterprise, and this is what we're doing. Teach them, train them, lend them the money, not give them the money, and the business skills, but probably very, very important to go with it too is community empowerment.

FRED DE SAM LAZARO: And you need to start it young?

MECHAI VIRAVAIDYA: Yes. Yes, start them young. When you start learning how to give when you're young, when you get older it's second nature. Just like stealing. Start young and you keep on stealing forever.

FRED DE SAM LAZARO: Mechai says he won't mind if more people steal this self-help model of building community and nation.

MARGARET WARNER: Fred's reporting is a partnership with the Under-Told Stories Project at Saint Mary's University in Minnesota.

How to Better Treat Trauma Injuries in the Developing World

Tue, 15 May 2012 18:39:00 EDT

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At San Francisco General Hospital, surgeons from developing countries are learning the latest techniques from top U.S. specialists. With just over 100 orthopedic surgeons serving the 80 million people of Kenya and Tanzania, it's admittedly a small step. But doctors there say it's a worthy one. Spencer Michels reports.

RAY SUAREZ: Modern machinery has caused a spike in injuries in the developing world. Now, a hospital in San Francisco aims to train doctors to treat them.

NewsHour correspondent Spencer Michels has our story.in

And a warning: This story does contains some graphic images.

SPENCER MICHELS: In recent years, the number of motorized vehicles on the roads in developing countries has skyrocketed, and so have the accidents.

DR. RICK COUGHLIN, University of California, San Francisco: We know that the global impact of injury in road traffic crashes is more than HIV, T.B., malaria combined. Did you know that? No one knows that. And yet that's the case.

SPENCER MICHELS: Rick Coughlin, an orthopedic surgeon at the University of California, San Francisco, is on a crusade to improve the care of those who sustain traumatic injuries in the developing world.

DR. RICK COUGHLIN: Anyone who goes to a foreign country, a developing-world country, your fear isn't that you're going to get HIV. Your fear is that you're going to be in a car accident and your leg is going to be exposed, and you're -- you're in trouble now.

SPENCER MICHELS: For the last four years, Dr. Coughlin has been spearheading a unique program which brings orthopedic surgeons from low-income countries around the world to San Francisco, to one of the country's leading trauma hospitals, San Francisco General.

MAN: And everyone has got covers.

SPENCER MICHELS: Five surgeons from Kenya and Tanzania recently arrived for a week of training and hands-on experience, learning the most up-to-date surgical techniques.

Dr. Nedford Ongaro is one of only 70 orthopedic surgeons in all of Kenya, a country of more than 40 million people. He says lack of supplies contributes to dangerous delays in treating traumatic injuries.

DR. NEDFORD ONGARO, Nigeria: We do not talk like surgical implants or surgical resources, so we give a prescription, someone has to go to buy hardware. That can take several days. So this accessibility is quite limited. And really that increases the burden, perhaps infections. People can lose limbs. And they don't get back to work that quickly. So they have quite morbidity.

SPENCER MICHELS: While accurate numbers are hard to come by, the World Health Organization estimates that for every person killed by traumatic injury, somewhere between 10 to 50 times more suffer non-fatal injuries, which often require advanced medical care. Without that care, the risk of amputation increases dramatically.

DR. RICK COUGHLIN: The global burden or global impact of amputation is quite enormous. There are enormous numbers of what we call open injuries, where the bone, especially lower leg injuries, the lower leg bones get exposed to the air, the dirt, become contaminated.

And the soft tissue surrounding those bones are injured. And now the bones are exposed. And in that capacity, if we can teach the surgeons how to cover these exposed bones in an expeditious fashion, then we eliminate the cycle of going down the path of infection, soft tissue infection, bone infection. And then the only salvage is an amputation.

MAN: The biggest issue with osteotomies is that you have some bone missing because, if you use a saw, it takes a tiny bit of bone away.

SPENCER MICHELS: On the day we visited, the surgeons from Africa were practicing on the elbow bone of a cadaver and the soft tissue around it. And they were learning how to drill and insert sophisticated orthopedic pins in artificial bones.

Dr. Edmund Eliezer from Tanzania says the training he's received, especially in techniques to prevent amputations, has saved more than limbs.

DR. EDMUND ELIEZER, Tanzania: Most of the times, these patients are the ones who are taking care of the families. So with the two legs, life is difficult. Now you can imagine, with the only remaining one leg, life would be very difficult.

SPENCER MICHELS: In much of Africa rural hospitals have few supplies. Heavy stones are sometimes used as traction devices. But both Dr. Ongaro and Eliezer work in the capital cities in their countries in fairly well-equipped hospitals.

Still, they say, they are having a hard time caring for the rising number of road traffic injuries.

DR. RICK COUGHLIN: So this is a mutual exchange.

SPENCER MICHELS: And, for his part, Dr. Coughlin says one main goal is to simply spread the message that traumatic injuries in the developing world are not getting the attention they deserve.

DR. RICK COUGHLIN: Why? Because HIV has the lobbying power and infection disease people have the lobbying power. I have no doubt in my mind that we are undersupplied, underfunded for research in this regard.

SPENCER MICHELS: The Kenyan and Tanzanian doctors say they will share the techniques and skills they have learned during their week in San Francisco with colleagues back home.

With just over 100 orthopedic surgeons in their two countries, serving a total of 80 million people, this program is admittedly a small step. But doctors here say they expect what they call a multiplier effect to spread the training to other surgeons in the developing world.

RAY SUAREZ: Last year, the United Nations launched the Decade of Action for Road Safety, which aims to prevent the loss of more than a million lives each year by 2020.

To learn more about the program highlighted in this report, click here.

For Cambodian Street Kids, Friends International Works to Redefine Normal

Wed, 09 May 2012 18:39:00 EDT

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From Cambodia, special correspondent Fred de Sam Lazaro reports on one group, Friends International, and its efforts to help homeless children and their families have a brighter future through education, shelter and health services.

GWEN IFILL: Next, helping homeless youth in Cambodia recover their childhoods and reach for a better future.

Special correspondent Fred de Sam Lazaro has our story.

FRED DE SAM LAZARO: Each day, workers with a group called Friends International try to redefine normal for street kids across Cambodia's capital, Phnom Penh.

In makeshift gatherings like this one, part kindergarten, part clinic, the children come to get cuts and scratches tended, to play board games, or, a rare luxury, to shampoo their hair. Normal for these children is a grinding work routine, scavenging in garbage dumps or, if they're lucky, peddling trinkets to tourists in this city of two million.

SEBASTIEN MAROT, founder, Friends International: You have about an estimated 20,000 children living and working on the streets of Phnom Penh. That is actually a huge number for a city like Phnom Penh, which is relatively small.

FRED DE SAM LAZARO: Sebastien Marot founded Friends International 18 years ago. It now serves 95 percent of this city's homeless youth. A former French foreign service worker, Marot took a break to visit the region.

SEBASTIEN MAROT: I arrived in Cambodia first of April '94, and found a situation that was very difficult to imagine when you see Cambodia today, no roads, no electricity, no running water. Everyone had guns and used them. It was -- the Wild West was the best description possible, so not a place you want to stay. But what happened is that I met kids.

FRED DE SAM LAZARO: He says he was moved by the plight of so many hungry children and decided to stay and find a way to get them into productive lives and off the street.

Those streets are being transformed today. The old temples and new high-rises are being spiffed up to attract foreign tourists and investors. But Phnom Penh has also lured thousands of children and their families from the impoverished rural areas of a country still recovering from the genocidal Khmer Rouge era between 1975 and '79, a period in which an estimated two million people died.

It's a difficult existence. The children are often forced to support the family, or at least fend for themselves. For many, it's a losing struggle, says Marot.

SEBASTIEN MAROT: The biggest problem we're facing now is actually the -- the serious increase in drug use in this population, which is relatively new. It started in late '90s. There was no drugs before. And, suddenly, it exploded, and now 80 percent of the kids are using, some glue-sniffing, a lot of amphetamine, and heroin is increasing.

FRED DE SAM LAZARO: The government, struggling to control the flow of drugs from neighboring countries, has responded with a crackdown on the street. The police are always on the lookout for young people like these, most engaged in petty crime and prostitution to support their drug habits.

SEBASTIEN MAROT: The government needs to show that there is no more street kid, that the cities are clean, so they do -- they destroy our building work by trying to get quick fixes. And that's putting kids in prison. That's cleaning the streets and putting people away, out of the eye. But that's not a solution.

FRED DE SAM LAZARO: Friends International, better known in the Khmer language as Mith Samlanh, is also on the lookout for these youth, but with a very different approach.

GIRL (through translator): Mith Samlanh comes here and they educate us about HIV and drugs and so on. We don't have enough to eat or a place to stay, so we take risks. We could be arrested.

FRED DE SAM LAZARO: Along with offering clean needles, condoms and lessons on safe behavior, Friends International counselors encourage these youth to come to a drop-in center for a meal or a bath, and, when they are ready, detox, a place to live and an education.

Twenty-three-year-old Sothea has lived on the street on and off for seven years. He has struggled with drug addiction, but returned to Friends for his fourth attempt to get clean and acquire job skills.

MAN (through translator): When I first came here, I wasn't comfortable. I wasn't ready for the learning environment, so I quit and went back out on the street to make money. Now the most difficult part is to try and keep myself away from drugs, from my friends on the street.

But I try not to go. I can quit drugs. I can stay away from these friends. I don't want to let my parents down again or my very good friends here at the program.

FRED DE SAM LAZARO: If he finishes, he'll have several options to develop marketable skills. Friends International offers training in everything from automotive mechanics to construction skills to hairdressing. Even after four attempts, Marot says there is a good chance he will eventually succeed.

SEBASTIEN MAROT: We haven't found really any child that was a lost cause, if you want. We work very hard with many children for a long time to be able to -- to get them to a level that was required, but we -- were always reasonably successful.

FRED DE SAM LAZARO: Friends International started and runs three of Phnom Penh's finest restaurants, training grounds for students and a source of income for its programs.

Seventeen-year-old Kunthea was recruited by Friends International on the street. She was selling flowers to support her family after her father died.

TEENAGER (through translator): My experience with Friends International has been great. Now I can read. And I love cooking the most.

FRED DE SAM LAZARO: But having Kunthea enter a training program meant she was no longer able to help support her family. She still lives at home with her mother and three siblings.

So an important part of the Friends International approach is to help not just the youth, but also their parents. It now employs Kunthea's mother, Sok Chenda, to sew handicrafts that are sold in its boutique, another business that funds Friends International programs.

SOK CHENDA, mother of student (through translator): Friends International helped me a lot. Without them providing me training and vocational skills, I could not feed my four children.

People say, why do you put your kids in Friends International? They won't make any money. Better to take your daughter to work in the garment industry, so she can make money.

But I don't. My children will have a better further than me.

FRED DE SAM LAZARO: Many graduates of Friends International have already gone on to a better future. In two years, Darun Rin says he picked up culinary and interpersonal skills and even a bit of English.

DARUN RIN, restaurant owner: They trained me how to -- like to cook the food, to serve the food to customer, and how to talk friendly.

FRED DE SAM LAZARO: Darun Rin got a job as a chef for the Singaporean ambassador, then went on to open his own restaurant, and is thinking of more.

DARUN RIN: To have maybe one more or two more. So, see, my plan like that, but we don't know yet. Let's see.

FRED DE SAM LAZARO: For every success story, however, there are many young people still struggling. Marot says the best shot at success is to intervene as early as possible in children's lives, to provide early childhood education before they can fall victim to drugs.

All this costs money. Restaurants and craft shops pay for about a third of Friends International's $6.5 million annual budget globally. Marot says it will take years to become self-sufficient and, until then, programs like these will depend on donations. Those have been hurt by the global economic slowdown.

SEBASTIEN MAROT: The current crisis is such that many of our donors just are not renewing contracts, have reduced their amounts, have less proposals than before. Luckily, we have these profits from the businesses that allow to bridge some, but that goes only that far, because our sustainability is -- is limited.

FRED DE SAM LAZARO: There are people watching who will say, you know, why doesn't the national government help you?

SEBASTIEN MAROT: Yes. And that's a very good question. In some countries, this is feasible. Say, for example, we should be able to access money from the Thai government, from Indonesian government. Cambodia, the budgets are not -- they're so donor-dependent themselves as a government.

FRED DE SAM LAZARO: Despite the funding challenges, the program now operates in eight countries in Southeast Asia and Central America, serving some 60,000 young people. And Friends International was recently invited to start a program for the first time in the United States. It will be in Las Vegas.

GWEN IFILL: Fred's reporting is a partnership with the Under-Told Stories Project at Saint Mary's University in Minnesota.

The Best and Worst Places to Be a Mom

Tue, 08 May 2012 18:42:00 EDT

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Norway is the healthiest country in the world to be a mother, according to a new report released by the international non-profit Save the Children. The worst: West Africa's Niger. Gwen Ifill and Save the Children President Carolyn Miles discuss what countries are best and worst at creating healthy children and mothers.

GWEN IFILL: We turn now to a new report which ranks the countries where mothers and their children are at the most and the least risk.

The international nonprofit Save the Children finds Norway the healthiest for the third year in a row, the worst, the West African nation of Niger. It replaced Afghanistan, which moved up one spot from last year. The United States ranked 25th.

For more on the report, we're joined by Save the Children president and CEO Carolyn Miles.

Welcome, Ms. Miles.

CAROLYN MILES, president, Save the Children: Thank you, Gwen.

GWEN IFILL: Give us a sense of what measures you're using to come up with these rankings.

CAROLYN MILES: Well, we looked at a wide variety of measures, really looking at things like child mortality, maternal mortality, the education of women and girls, economic empowerment of women, even the political involvement of women, because all of those give us a good indicator of the status of women in those countries, which really impacts what it's like to be a mom there.

GWEN IFILL: So, what. . .

CAROLYN MILES: We also looked at things like maternity leave, so all sorts of factors.

GWEN IFILL: So what's the difference in the end in the rankings between the top 10 and the bottom 10?

CAROLYN MILES: Well, it's interesting.

They're really kind of almost a mirror of each other. So all those indicators I talked with -- about are great for the top 10, and they're all quite poor for the bottom 10. So an example would be if we compare Norway and Niger, as you said, number one and number 165.

So, in Niger, only one in three births are attended by any kind of skilled attendant. And some of these births are actually women giving birth all by themselves, whereas, in Norway, virtually every birth is attended by a skilled birth attendant.

Things like education rates for girls, so about four years on average in Niger, 18 years in Norway. Probably, for me, as a mom, the most shocking statistic actually from this year's report is that, in Niger, virtually every mother will lose a child before the age of 5, will lose one of her children. So that to me, as a mom, is a pretty shocking statistic, so really across the board.

GWEN IFILL: It's a pretty shocking -- it's pretty shocking statistics. And I wonder how much of this is also driven by malnutrition not only involving the mothers, but also the children.

CAROLYN MILES: Yeah, we really looked at malnutrition this year as a huge factor and looked at hunger; 170 million kids across the world are malnourished. That's about one in four children.

And that has a big, big impact on child health. So of the seven-and-a-half million kids that die under the age of 5, about a third of them are malnourished. So when a child gets sick, they die from very common illnesses if they're malnourished.

GWEN IFILL: I was also interested in something in the report about educational attainment for girls. That's -- you wouldn't think about that as having to do with health, necessarily.

CAROLYN MILES: Well, the reason it's a key indicator in this report is that we have actually done a lot of work on this issue. The longer you keep girls in school, the longer they delay having their first child. And that child will be much healthier.

A girl who has a baby at 14 is a much higher-risk pregnancy and a much higher risk for that baby than if the girl waits until she's 17 or 18. And if she stays in school, it's much more likely she is going to wait until she's older. So that's why girls' education is actually so important.

GWEN IFILL: I was also interested in the -- in the status of Afghanistan which was dead last, last time you took this report, and now has moved up. What happened in Afghanistan?

CAROLYN MILES: Well, there actually are some good bright spots in this report, and Afghanistan is one of those.

Afghanistan did move up. It doesn't sound like a lot, but moving up from last to not being last anymore is big. And a lot of that was driven by education rates, actually. So the years and years that people have been working on getting girls into school is really starting to show up in terms of the health of mothers and of babies there. So that was a big change.

GWEN IFILL: And also the -- and also the proliferation of community health centers from -- I think from 2,500 in 2008 to 22,000 now, that's a lot.

CAROLYN MILES: That's right.

And a lot of these health centers are in the places where moms and babies do die, kind of at the end of the health system, if you will, at the end of the road, really remote areas where these moms are oftentimes giving birth at home. So, having a health clinic close at hand really saves lives.

GWEN IFILL: And, finally, I have to ask you, why is it that the U.S. ranks 25th? You would assume, if it wasn't number one, it would at least be in the top 10 or the top 20.

CAROLYN MILES: Yes. I think the number 25 for the U.S. is really surprising. Actually, the U.S. moved up six spots this year, so we were 30 -- the U.S. was 31 last year.

But we still have very high rates, relatively, of maternal mortality in the country. One in 2,100 births result in the death of the mother. And we still have some very high rates of child mortality as well. So it's because of poverty in the United States, the big gap between health care that's available for well-off women vs. very poor women, and that's really a huge gap still in the United States.

GWEN IFILL: Carolyn Miles of Save the Children, thank you so much.

CAROLYN MILES: Thank you, Gwen.

GWEN IFILL: You can find a slide show of the best and worst places for maternal and child health on our website.

Norway's Moms Have It Good

Tue, 08 May 2012 08:20:00 EDT

Norway is the best country in the world to be a mother, according to a new report from the international nonprofit Save the Children. Niger replaces Afghanistan as the worst country for moms. Afghanistan had been at the bottom of the list for the previous two years.

The 13th annual State of the World's Mothers report ranked the well-being of mothers in 165 countries - 43 developed nations and 122 in the developing world - based on a variety of criteria including health, nutrition, education, and economic and political status. Countries that did not release sufficient data were not included in the study.

At 25th in the world, the U.S. jumped six spots from 2011. "While the U.S. has moved up in the rankings, ahead of last year's 31st place, we still fall below most wealthy nations," said Save the Children President and CEO Carolyn Miles in a statement. "A woman in the U.S. is more than seven times as likely to die of a pregnancy-related cause in her lifetime than a woman in Italy or Ireland."

In addition to the country rankings, the report highlights the important role nutrition plays in the overall well-being of mothers and their children.

"I think the major message from the report is what we call the hidden crisis of malnutrition -- 170 million kids are suffering from malnutrition. It's something that has a big impact on the country rankings," Miles told the NewsHour. "It kills kids. So it is a big issue when it comes to being a mom."

According to Save the Children, malnutrition is the underlying cause of at least one-fifth of all maternal deaths and more than one-third of child deaths worldwide.

Best and Worst Countries for Moms

Mon, 07 May 2012 17:43:00 EDT

Save the Children Report: Best and Worst Countries to be a Mom

Why Clean, Safe Water Is Still Out of Reach for Liberia

Wed, 25 Apr 2012 18:47:00 EDT

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Since 1980, Liberia has tackled a cycle of civil war, claiming over 200,000 lives while developing an impossible water crisis. In partnership with the Pulitzer Center on Crisis Reporting, correspondent Steve Sapienza and two local journalists unearth why the government and aid agencies can't crack the country's water problems.

GWEN IFILL: Finally tonight, a West African country struggles to recover from years of conflict and aims to provide its citizens with very basic needs, including safe drinking water.

Special correspondent Steve Sapienza has another of his collaborations with African journalists covering the continent's water issues.

His story was done in partnership with the Pulitzer Center on Crisis Reporting.

STEVE SAPIENZA: Since 1980, the West African nation of Liberia has been through a cycle of bloody civil war that has claimed over 200,000 lives.

Reporter Tecee Boley survived the turmoil and is now pushing the government to tackle a water crisis that arose during the war years, a crisis that is still claiming lives today.

Radio journalist Tecee Boley wants to know why a reliable supply of clean water to Monrovia's slums remains outside the reach of government and aid agencies. I met Tecee at the Liberian Women's Democracy radio station on the outskirts of the capital. Her drive to report about Liberians' daily struggle to find clean water was undoubtedly shaped by growing up in a war zone.

TECEE BOLEY, Liberian radio journalist: When the war was really hot in Liberia, I would get up early morning to fetch water for my mom. As soon as the shooting subsides, I would go sneak, get a bucket or two, and come indoors. There was no other alternative. We needed the water. Otherwise, we would die.

STEVE SAPIENZA: During the war, tens of thousands of Liberians fled the violence in rural areas in search of food and shelter in the capital. A decade later, Monrovia's slums remain badly overcrowded, and those who eluded war now face new dangers.

TECEE BOLEY: There's a high demand for clean water now in these areas because the population overstressed the already limited services.

STEVE SAPIENZA: At the Randalls Road slum, a group of war amputees tells Tecee that their pump hasn't worked in over one month, a heavy burden to those living on less than a dollar a day.

TECEE BOLEY: The water source itself, when we went to that community, you see there is a hole dug around the well. That means somebody who is physically challenged can't get there to get the water.

MAN: To get water here is hard. I have to pay someone to get to the well and buy the water and bring it to us, so that we can get water to take bath.

STEVE SAPIENZA: 18 percent of all deaths here are caused by waterborne illnesses like diarrhea, malaria and cholera, according to the World Health Organization.

One recent World Bank study found E. coli, an indicator of widespread fecal contamination, in 58 percent of water sources across Monrovia. These are sobering statistics for President Ellen Johnson Sirleaf, who is recognized internationally for her work on water issues.

She pledged in 2008 that water access in Liberia would double in four years. Achieving this target is the job of the Liberia Water and Sewer Corporation and its managing director, Nortu Jappah.

TECEE BOLEY: I visited a community yesterday, and I want to know why the water supply to that community is irregular.

NORTU JAPPAH, managing director, Liberia Water and Sewer Corporation: Okay, so I think I have talked about the issue of our capacity issue. We ration water. Most of our infrastructure have lived their useful lives, and at the end of the day, most of it needs to be replaced. And we have had constant breakdowns of machines and pumps.

And so it's our plan that once we have some of these technical issues reckoned with or so, we will be able to get water to Monrovia in its entirety.

TECEE BOLEY: How soon do we expect to see. . .

NORTU JAPPAH: I would assume that probably just by the end of the year.

STEVE SAPIENZA: As proof the government was on target, Mr. Jappah cited a recent project.

NORTU JAPPAH: For the past 21 years, there has not been water on the Somalia Drive area. Just recently, the president and I, we dedicated or opened the first water main since 1990, so people along the Somalia Drive now have pipe-borne water.

STEVE SAPIENZA: Curious to see if rhetoric matched reality, Tecee left the interview and went straight to Somalia Drive. After several hours of fruitless searching, she found no evidence of water flowing from city pipes to local taps.

TECEE BOLEY: Since the war, it only came once.

Tecee did find a local man profiting from the water shortage by reselling bags of water. But he also had seen no proof the city was pumping water to his neighborhood.

MAN: Before the war, there was water all around here, but now we don't know what is the problem.

STEVE SAPIENZA: Kulah Borbor fled heavy fighting in the interior during Liberia's civil war and came to West Point, one of Monrovia's largest slums. She arrived with her husband and four young children, only to face another battle.

KULAH BORBOR, Liberia: When we get here, we started drinking good water. It went bad with a bug that hit our stomach, so he didn't make it.

STEVE SAPIENZA: When cholera took Kulah's husband, she thought about going back to her village. But she stayed, and now teaches her neighbors how to purify water and prevent deadly diarrhea in infants. This is lifesaving knowledge in a slum of 60,000 people, where most residents buy suspect water from vendors or fetch water from dirty wells.

TECEE BOLEY: How do you feel when you save someone's life with that solution you made there?

KULAH BORBOR: I feel happy because I don't want people to be like me. So, I feel happy, because when I lose my husband, I suffer with my children.

TECEE BOLEY: And the president said that there are water supply to a community like West Point. And, clearly, we went to West Point. There is no pipe water there. There's no pipe water. The people in West Point will have to buy the five-gallon container of water.

STEVE SAPIENZA: Unfortunately, the rising urban population and waterborne illnesses are spreading faster than city pipes.

TECEE BOLEY: Some of these people who work in government, they have people who are working under them in the various departments. They come back and paint a picture like everything is fine. And, actually, they are not fine. I think the bosses themselves have to go on the field and see the reality.

STEVE SAPIENZA: Tecee's reporting exposes the gap between the Liberian government's claim it has addressed critical water problems, and the actual conditions faced by Monrovia's residents.

Until the government solves the problems, many more Liberians who fled the war, leaving towns and villages behind, risk losing their lives to a new foe: unsafe water.

GWEN IFILL: You can learn more about West Africa's struggles to get access to safe drinking water. There's a link to the Pulitzer Center's stories on our website.

In Liberia, Political Battles Center on Water Access

Wed, 25 Apr 2012 16:54:00 EDT

A vendor sells water in Monrovia, Liberia. Photo by Sumaya Agha.

"Water! Water!" Eugene Seoh shouted from his three-story apartment building on Benson Street, a main avenue in the center of Liberia's capital, Monrovia.

From across the road, water vendor Jerry Worlogar looked up and nodded. Seoh hurried down the stairs. He stood before Worlogar's hand-drawn cart full of white 5-gallon containers.

"Thirty-five (Liberian) dollars for one gallon," Worlogar told Seoh.

"Every day your price is changing," Seoh complained.

"That's dry season," Worlogar said. "You know the water business is hard."

Water business in Liberia is indeed hard. Like many in central Monrovia, Seoh has to search for water every day. He and his wife, Louise, who is seven months pregnant, get up before dawn to trudge up and down three flights of stairs to retrieve water from the building's well. More than half of Eugene Seoh's monthly income goes to buying water.

Measuring Progress

Seoh's struggle does not show up in the country's development reports. The Liberian government submitted information to the World Health Organization and UNICEF Joint Monitoring Program that estimated 8 percent of households in urban areas have piped water and 88 percent have access to an improved water source. Living in the heart of the the Liberian capital, Seoh should be one of the few Liberians who do have piped water. He does not.

Theophilus Addey, the acting deputy national coordinator of the Liberia Reconstruction Development Committee, said these figures are just a guide for the government.

"Are they precise?" said Addey. "It's hard to say. The numbers give us the means to say how much progress has been made."

Not only the numbers are questionable; the government is also making suspect claims about specific water access projects. The managing director of the Liberia Water and Sewer Corporation, Nortu Jappah, said in an interview in November that he and President Ellen Johnson Sirleaf had recently opened a water main to serve the string of neighborhoods along Somalia Drive. The area has not had piped water for more than two decades.

Somalia Drive still does not have piped water. In hours of searching following the interview with Jappah, just one tap was located. Its owner said it had run just once since the end of the civil war in 2003 -- and that was in the lead-up to the presidential election in October.

'The Water Is Not Safe'

Despite the uncertainty and discrepancies, donors make decisions on how to aid the government based on these statistics.

For example, the U.S. Agency for International Development recently approved a grant for water and sanitation in Liberia that included significant funds for sanitation but a smaller allocation for water than in the past.

Justifying the distribution, a USAID spokesperson said that "USAID (and) Liberia's decision to place an emphasis on sanitation access over water supply access was largely based on the relatively high level of access to improved water supply in Liberia, compared to the very low level of current access to improved sanitation facilities."

Access to sanitation is very low -- just 25 percent as of 2008, according to World Bank statistics. Civil society groups in Liberia argue that the current water situation is actually not much improved.

Prince Kreplah heads a consortium of organizations working on water and sanitation issues in Liberia and challenged the reliability of the UNICEF Joint Monitoring Program statistics.

"I don't know what you call 8 percent having access to pipe water," said Kreplah. "Is it just running the pipe into someone's yard and there's no water in it because the system has broken down?"

Addey stated pipes are not the only source of safe drinking water. "A hand pump, a hand-dug well may provide safe drinking water based on the treatment," he said. The government has provided many such hand pumps and wells to communities across the country, according to Addey.

But Kreplah said that the majority of these do not supply the quantity of water needed by Liberians.

"Most of the wells have run dry; most of the hand pumps have run dry because the water system is no longer working effectively," said Kreplah. "The country is facing a serious water crisis."

"If you go to clinics and hospitals around our country, you find most of the patients admitted here are people admitted from water-borne and sanitation-related illness," he said.

Seoh buys a bottle of antiseptic solution every week to purify water used for bathing in an attempt to prevent an aggressive rash from attacking his wife's skin. But this has done little to stop the problem. Seoh took his wife to a hospital, where he said doctors confirmed that the water he buys was the cause of her inflamed skin.

"The water is not safe," he said. "It's dirty, very dirty water."

An 'Overambitious' Plan

In 2008, the Liberian government launched the Poverty Reduction Strategy, or PRS, to chart the nation's course to development. Among other goals, the plan promised that access to water would double in four years.

Since then, little has been done to replace old infrastructure damaged during Liberia's civil war, according to Silas Siakor, director of the Sustainable Development Initiative Liberia.

"There is absolutely no way that 1 percent of the people (in counties outside the capital) will have access to pipe-borne water by 2015, not even by 2020. I could bet my head on that," said 41-year-old Siakor. "People my age in Lofa should not even dream of having pipe-borne water in their lifetime. I am not even going to talk about 2020 or 2030. When leaders make these pronouncements knowing that it is untrue, I've got a problem with that."

The government's own reporting shows failure.

By the end of 2011, the government's final assessment report on the PRS plan showed only seven of 22 goals related to water and sanitation were completed. Only two were of physical projects with direct benefit to the people. The rest were plans and studies.

"Under water and sanitation -- I'm not talking about the other ones -- the PRS failed miserably," said Kreplah. "We said we wanted to do boreholes filtered with hand pumps; we have not developed 5 percent of the total boreholes under the PRS. Because of lack of resources, they were not delivered. That PRS report is something to be challenged."

Addey conceded that the goals and timeline for water and sanitation were unrealistic. "In some instances, I think we were overambitious," he said.

Kreplah put the blame elsewhere. In the years prior to October's presidential election, he said, the government focused on short-term projects for political gain rather than long-term progress on water and sanitation.

"We budgeted more for other parts of the development agenda that people see as very tangible and have political dividends, compared to water and sanitation, which more political leaders thought were not sexy enough politically to win the attention of people, so as to attract more votes," said Kreplah.

Although financial resources may be in short supply for water and sanitation, rhetorical resources are not. Sirleaf has staked a significant part of her reputation on bringing water to the people of Liberia. She currently serves as the WaterAid goodwill ambassador for water and sanitation to Africa. In August, Sirleaf wrote an op-ed in the Washington Post thanking Americans for their generosity to Liberia and emphasizing her efforts and intentions to increase access to water and sanitation.

As the sun set on Benson Street in the heart of Monrovia, Seoh cautiously eyed the containers to be sure he chose one with clean water. He put down a gallon with dark green algae in it and picked up another one that looked better. Regardless of whether this water is safe or purified, Seoh said he is lucky. There are many days that he and his wife cannot even get water to bathe.

Tecee Boley is a Liberian print and radio reporter. She received a grant from the Pulitzer Center on Crisis Reporting and is a New Narratives fellow.

On Wednesday's NewsHour, special correspondent Steve Sapienza reports in collaboration with African journalists on the water crisis in West Africa.

Solar Suitcase Report Spurs Gifts to Aid Baby Deliveries in Developing World

Thu, 19 Apr 2012 15:18:00 EDT

A Liberian midwife learns how to maintain and clean a newly installed solar suitcase.

PBS NewsHour correspondent Spencer Michels recently reported on the Berkeley, Calif., nonprofit We Care Solar, which developed a "solar suitcase" to provide lights and communications equipment in delivery rooms and health care facilities in developing countries.

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Co-founder Dr. Laura Stachel reports that NewsHour viewers were quick to offer their support. "The response to the PBS segment was tremendous," she said. "We received inquiries from potential volunteers, engineers wanting to help craft our suitcases, and organizations looking to light up clinics in the developing world."

Since the report first aired on April 4, We Care Solar has received more than $8,000 in donations. Stachel says those contributions will have a big impact, enabling her organization to provide five new $1,500 solar suitcases to clinics in need. "Most clinics have 250-750 deliveries a year," says Stachel. "So in one year, these solar suitcases will serve approximately 2,500 mother-infant pairs."

We Care Solar's website received nearly 2,000 hits the day the segment was broadcast, compared to about 60 visits a day before, and Stachel says the site continues to get a steady flow of traffic.

"We've had inquires come to us as far as Australia," reports Stachel. "We've received donations ranging from $5 to $1,000. We are touched by the $5 donations. We realize when people donate something small it really means something to them, and it is equally meaningful to us."

Over the coming months, Stachel hopes to continue spreading the word about electricity shortages in the developing word through several high-profile partnerships. On Earth Day, this Sunday, We Care Solar is teaming up with the Grammy Award-winning band Linkin Park to promote solar suitcase projects in Uganda.

And Stachel is currently organizing a workshop in Washington, D.C., in May with the UN Foundation and the World Health Organization which will focus on energy issues and health.

Click here for more of the NewsHour's Global Health coverage.

Will Water Pumps Bring Peace to Ivory Coast?

Wed, 11 Apr 2012 18:45:00 EDT

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Part of a partnership with the Pulitzer Center on Crisis Reporting, special correspondent Steve Sapienza reports from the West African nation of Ivory Coast and explains how committees set up to maintain access to water are helping bring together communities divided along ethnic lines and plagued by the unrest of a civil war.

JUDY WOODRUFF: Next tonight: A civil war in West Africa forces a country to look at its water problems.

Special correspondent Steve Sapienza has another of his collaborations with African journalists who are covering the continent's water issues.

His story is from the Ivory Coast, and it was done in partnership with the Pulitzer Center on Crisis Reporting.

STEVE SAPIENZA: The West African nation of Ivory Coast was once a beacon of prosperity for the region. But, in 2002, a civil war divided the country between north and south, and set the stage for further turmoil.

Recently, violence erupted in 2010, when incumbent Laurent Gbagbo refused to cede power to Alassane Ouattara after a disputed presidential election.

I met journalist Selay Kouassi on the rooftop of his apartment building, the spot where he watched his country descend into chaos.

SELAY KOUASSI, journalist: I was here, standing here on my rooftop, and I could see U.N. helicopters and helicopters of French troops shooting rockets on the presidential palace. It was something nobody experienced before.

STEVE SAPIENZA: Selay continued reporting from the streets of the port city Abidjan as war engulfed the entire country, killing thousands of people and leaving nearly a million homeless.

The civil war ended when Laurent Gbagbo was captured in April of 2011. But armed militias linger and sporadic fighting still occurs to this day. In the country's western region, intercommunal violence divided villages and destroyed some 18,000 homes.

Far from the reach of the central government, villagers in the west have been left to mend rifts on their own. I followed Selay to this still tense region, where once bitter rivals are uniting around a common need: water.

SELAY KOUASSI: Water is a very important resource. And in the village, people usually meet at the water points. It's where people meet to share news, to just speak with others.

STEVE SAPIENZA: The conflict divided many villages along ethnic lines, which led to broken and blocked water points.

MAN (through translator): Before the war, the water pump was repaired and working and the water was here. Since the war, the population fled and everything was abandoned, and so today we still need to have access to water.

WOMAN (through translator): We were hiding in the bush and we were drinking dirty water. When we returned, some of the wells had bodies in them, and they said the water is dirty.

STEVE SAPIENZA: Before the war, one ethnic group, the Yacouba, controlled the water points of this village. Today, water is managed by several ethnic groups.

VICTORIEN TOUALY GBLA, water committee spokesman (through translator): The committee is comprised of several different ethnic groups, Yacouba, Dioula, even the Mossi. We did this because when the committee is exclusively comprised of Yacouba, the Dioula feel discriminated against. That's why we have this arrangement, in the spirit of the reconciliation.

SELAY KOUASSI: Most of the water committees I visited were neither set up by the government nor by the international NGOs working in the area.

They started this initiative on their own. And it's really fantastic, because maybe they learned from the crisis and its negative impact on their own lives and neighborhood.

STEVE SAPIENZA: In Teapleu, where the war began, the water committees are taking root. But the village chief tells Selay more needs to be done to repair broken hand pumps and to cover exposed wells.

BAGUI PLEIZAN DENIS, chief of Teapleu (through translator): This what we are using. We're drawing water from here. If you drink water from here, it is hazardous. It's like this all around the region. Because of a lack of means, all the wells are open wells without covers.

STEVE SAPIENZA: The water committees here receive no help from the Ivorian state. And the government representative in Teapleu, N'Cho David, is skeptical water will unite divided villages.

N'CHO DAVID, Sub-prefect of Teapleu (through translator): To expect that water will be a tool through which reconciliation will occur is going too fast.

STEVE SAPIENZA: The government has been slow to embrace village water committees. But international aid groups are supporting them, says Benjamin Doua of Save the Children.

BENJAMIN DOUA, Save the Children (through translator): From our perspective, we want to organize the different communities around the water issue for peace.

STEVE SAPIENZA: But Teapleu official David prefers that aid groups make fixing broken water pumps a priority.

N'CHO DAVID (through translator): I want Save the Children to repair all the pumps if possible to ease the suffering of the people.

STEVE SAPIENZA: As the government waits for outside help, the village chief worries the exposed wells may lead to renewed violence.

BAGUI PLEIZAN DENIS (through translator): Recently, a group of people were coming to pour poison into the wells, and we were being vigilant. So two of my young brothers handed them over to local authorities. Otherwise, Teapleu would have another conflict.

SELAY KOUASSI: In terms of reconciliation and peace, water committees in the villages are a step forward. What they have already down in terms of reconciliation is great. And they just need support now, to be backed by the government, to go ahead and give peace a chance.

STEVE SAPIENZA: The government has formed a truth and reconciliation commission to heal the country's deep divisions. Villagers say national reconciliation programs haven't reached them yet, but they know where reconciliation will start here: at the village water point.

JUDY WOODRUFF: You can learn more about why much of West Africa struggles to get access to safe drinking water. There's a link to the Pulitzer Center's stories on our website.

'Tinderbox': How Colonialism Shaped the HIV/AIDS Epidemic

Tue, 10 Apr 2012 18:43:00 EDT

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Ray Suarez speaks with authors Craig Timberg and Daniel Halperin about how "shadows of colonialism" hang over the spread of HIV from Africa. The topic is explored in their book "Tinderbox: How the West Sparked the AIDS Epidemic and How the World Can Finally Overcome it."

JEFFREY BROWN: And finally tonight, a new book explores the history and spread of AIDS in Africa.

Ray Suarez has our conversation.

RAY SUAREZ: Since AIDS was first identified in the West 30 years ago, its toll across the world has been vicious. It's killed 25 people since 1981. An estimated 34 million are living with the virus today.

Just how the disease began and spread perplexed scientists for years. A new book tracks the emergence of the HIV virus out of a remote part of Cameroon to what is now Kinshasa in the former Belgian Congo. "Tinderbox: How the West Sparked the AIDS Epidemic and How the World Can Finally Overcome It" connects the economies and atrocities of colonialism to that initial outbreak and to current medical approaches to the treatment and prevention of HIV in Africa.

Craig Timberg and Daniel Halperin, welcome.

DANIEL HALPERIN, author: Thank you.

CRAIG TIMBERG, author: Thank you for having us.

RAY SUAREZ: The book is about a great many things, but one of the conclusions that's gotten a lot of attention is the responsibility of colonialism for helping AIDS break out of the deepest rain forests into the rest of the world. How does that happen?

CRAIG TIMBERG: Well, the virus that became HIV was infecting a community of chimpanzees for hundreds of years, probably thousands of years. And scientists now theorize that it actually made its way into the human population several times over centuries.

As humans caught infected chimps, butchered them, the blood probably passed through a cut. What's crucial about the moment that leads to the actual AIDS epidemic is that at that exact moment, there are new intrusions of steam ships and porter paths as humans move into these remote places where the chimpanzees lived.

And it's at that moment when HIV becomes a human epidemic, starts moving down the rivers and into the birthplace of the epidemic, if you will, in Central Africa.

DANIEL HALPERIN: And even to this day, there are small strains of HIV virus that exist. For example, in Cameroon, there are more strains of the virus than anywhere else in the world.

And some of these strains probably originated during the last century, in other words, are more recent than the strain that has caused over 99 percent of the deaths by AIDS in the world. So we hypothesized that if it hadn't been for the role of colonialism, that what we now know today as the type of HIV virus that has become this hugely global problem might likely have become like these other strains we have seen in Cameroon. It may have gone out and infected a few hundred or a few thousand people. But we may never even have known about it because it's a fairly remote part of the world.

CRAIG TIMBERG: And this is a place that was one of the most sparsely populated parts of a very sparsely populated continent.

And so were it not for the intrusions of colonialism, it's unlikely that the epidemic we know today would have come out in the way that we have seen it, and in particular that they have been able to track porter paths, where Africans are force marched to the jungle. They're carrying guns and ivory tusks and rubber. They have been able to track that to exactly the place where these chimpanzees lived.

And there would have no reason for those people to go there before. They went there because they were forced to go there. And they come down these porter paths, they go to these trading stations, they get on steam ships. And that becomes the actual spark for this epidemic.

DANIEL HALPERIN: We can now see in retrospect that this was going on.

And that perhaps gives us a little bit insight hopefully into how to approach the problem today, that, as Westerners, we are not merely bystanders who care about what happened in Africa, but in a sense we have a little bit perhaps of responsibility to help remedy a situation that we may have partly helped to have initiated.

RAY SUAREZ: What happened in later decades, in the '60s, '70s, and '80s, to allow HIV to become so deeply rooted in Africa and also break out to the rest of the world?

CRAIG TIMBERG: The two very important things happened in the middle part of the 20th century.

One is that HIV makes its way on the railroads, on the highways into the parts of Africa where male circumcision, which is an ancient tradition in much of the continent, is not in fact a tradition. So when you cross over the mountains, and you're suddenly in East Africa, you're in the areas where men aren't circumcised.

And, suddenly, instead of having infection rates of 1 percent, 2 percent, you get infection rates of 5 percent, 10 percent, 15 percent. You see the kind of the disaster that we're more familiar with, where entire villages, you know, lose a huge percentage of their adults.

And that kind of problem also moves into Southern Africa, where also you have lower rates of male circumcision. And the other crucial thing that happens is HIV makes its way to the Americas. It makes its way from Kinshasa in the 1960s to Haiti. And that's where eventually it works its way into the Americas, it works its way into the gay American population, and it spreads much more widely eventually.

RAY SUAREZ: But the shadow of colonialism is never really gone from Africa, is it? When it comes to the way we look at AIDS, look at AIDS sufferers, talk about and to the people who are HIV-positive, how do you explain that part of it in your book?

DANIEL HALPERIN: We believe, of course, that the Europeans and North Americans and other foreigners who are in Africa now and other places trying to help people with epidemic are in one sense completely different from the colonials who were there a hundred years ago. They're not there to rape and to plunder, so to speak.

They're there with good intentions. They want to help deal with this and other diseases. But there's unfortunately a little bit of a kind of paternalism or a hubris maybe that continues, a sense of, we're the experts, we know what to do.

RAY SUAREZ: There's been a lot of coverage in the book of the sort of condescending, paternalistic, tsk-tsk way of looking at African societies where people were changing their behavior and not getting much credit for it.

CRAIG TIMBERG: When you look at what happened in societies when they faced this problem, several of them sort of did the math. Right? They were faced with an incurable disease. It was spread by sex. It was fatal.

And in several societies, the leaders of the societies, politicians singers, religious singers, led campaigns in which they said, if we're going to survive, we need to make changes in our own sexual behaviors as a society. And that ends up being enormously consequential when you're dealing with a sexually transmitted epidemic.

RAY SUAREZ: You don't have a lot of love for the efforts to use high-tech responses, particularly in the African epidemic, whether it's antiretrovirals or universal urging to use condoms. Sort of technical fixes don't really get a lot of praise in this book.

And I think you conclude that they're not going to work in the African context. Why?

CRAIG TIMBERG: These drugs are miraculous, right? This medicine brings people back from the edge of death.

And anyone who's watched that happen understands the power of that. And we want as many people to be treated as possible. And what -- the issue we raise is, it's not enough to treat people who already have this virus. To really win the fight against the epidemic, you need to prevent the next million, the next 10 million infections from happening.

And, now, drugs may play a role in that, but we think that the most powerful role in the end will be played by the kind of things we're talking about here, changes in sexual behavior, increasing the prevalence of male circumcision. And that's what history shows.

RAY SUAREZ: The book is "Tinderbox: How the West Sparked the AIDS Epidemic and How the World Can Finally Overcome It."

That's a pretty big ambition in that title.

(LAUGHTER)

RAY SUAREZ: Craig Timberg and Daniel Halperin, thank you both.

DANIEL HALPERIN: Thank you, Ray.

CRAIG TIMBERG: Thank you, Ray.

DANIEL HALPERIN: This was wonderful.

'Solar Suitcase' Sheds Light on Darkened Delivery Rooms

Wed, 04 Apr 2012 18:29:00 EDT

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After witnessing the consequences of power outages in Nigeria's health facilities, obstetrician Dr. Laura Stachel came up with a solution: a suitcase containing elements to produce and store solar energy. Spencer Michels reports on the life-saving device that aims to reduce maternal mortality rates in the developing world.

JUDY WOODRUFF: Next, a California couple develops a small and innovative solution to a power problem that's causing thousands of deaths a continent away.

NewsHour correspondent Spencer Michels has the story.

SPENCER MICHELS: In crowded hospital emergency and delivery rooms, the pressure is on and so are the lights. In fact, electricity powers dozens of medical devices, keeping patients alive: heart monitors, refrigerators for bags of blood, ventilators.

But imagine if a doctor was delivering a baby or performing an operation and the lights suddenly went out.

WOMAN: Welcome to the world, little one. And the lights are. . .

DR. LAURA STACHEL, WE CARE Solar: We estimate that 300,000 health facilities do not have reliable electricity around the world. So this is a huge problem.

SPENCER MICHELS: Berkeley, Calif., obstetrician Dr. Laura Stachel has witnessed power outages and their often tragic consequences in health facilities throughout Africa.

DR. Laura Stachel: I would watch C-sections where the lights would go out and the doctors literally finished with my own flashlight. I watched women fighting for their survival in the labor room with complications, and the only light was a kerosene lantern that barely provided any illumination.

SPENCER MICHELS: After a back injury ended her career delivering babies, Stachel visited a maternity ward in northern Nigeria in 2008 to learn why so many African women were dying in childbirth.

Nigeria has one of the highest maternal mortality rates in the world. Tens of thousands of women die there each year while giving birth.

DR. LAURA STACHEL: I had expected that maybe women were dying from very unusual conditions.

But what I saw were conditions that I had treated as an obstetrician for years in this country, but I had never associated with death. So, things like high blood pressure can be treated with medication. Someone who has a baby too big to fit through the birth canal can get a C-section for delivery. A number of the conditions -- I saw infections. They need antibiotics. But all of those things depend upon procedures that depend upon light.

SPENCER MICHELS: The hospital Stachel visited was actually connected to the local power grid, but as in many low-income countries, electricity was unreliable. And, worse, most rural health facilities aren't even connected to a power grid.

Stachel decided to enlist the help of her husband, Hal Aronson, a self-taught solar expert and teacher, to help light the maternity ward.

HAL ARONSON, WE CARE Solar: I thought, wow, what an opportunity for solar. It's very simple to do a stand-alone solar electric system that will keep the lights on all night.

SPENCER MICHELS: In the backyard workshop of their Berkeley home, Aronson quickly began designing a solar-powered battery system that Laura could take back to the hospital.

HAL ARONSON: So I built something that was basically like this, which is just a piece of plywood. Here, I'll turn it where you can see it. And this is the charge controller. This is the battery to store the energy. And then these wires would go out to a solar panel.

SPENCER MICHELS: Stachel insisted on a few refinements.

DR. LAURA STACHEL: I said, could you make this easy enough for me to use and make it small enough that it will fit in my suitcase? Because I'm hoping to get through customs without a lot of raised eyebrows.

SPENCER MICHELS: The prototype she delivered to the hospital and a subsequent larger solar installation which powered lights and a communications system had dramatic effects. She says maternal mortality rates in the hospital dropped by nearly 70 percent.

DR. LAURA STACHEL: What we were told was that they were able to provide care through the night much more easily. Nurses told us they were no longer afraid to go to work at night, that more patients began to come to the clinic, that they didn't delay certain procedures until the morning.

SPENCER MICHELS: Three years and six models later, Aronson and Stachel have turned their creation into a rugged, self-contained system they call a Solar Suitcase. And they've founded a nonprofit to build and distribute them called WE CARE Solar -- 160 of the devices are currently being used in 17 different countries, including Haiti after the 2010 earthquake.

HAL ARONSON: When you open it up, you have a complete solar electric system. There's the solar panel right here. Over here's the battery. This is the charge controller, so I have got the light here. And this is a switch for the lights. And you're lit up.

SPENCER MICHELS: It works.

(LAUGHTER)

HAL ARONSON: It works.

SPENCER MICHELS: Is this enough light to deliver a baby or do a C-section or whatever?

HAL ARONSON: Absolutely. If it was dark, I could show you that this will actually light up a small room.

SPENCER MICHELS: Currently, each of the suitcases costs $1,500. And they contain two solar panels that are installed on the roofs of clinics. The panels charge the battery in the suitcase, which can be mounted on a wall or kept portable.

When fully charged, the battery can power two LED lights for nearly 20 hours. The case also provides outlets to charge communications equipment like walkie-talkies and cell phones. The system was designed to be easy to install and operate by local health workers and to withstand heat, rain and harsh treatment.

HAL ARONSON: I'll turn this on and check this out. That is a reasonably durable light.

SPENCER MICHELS: Wow.

HAL ARONSON: If they drop it, it still works. And that was very important, because, you know, lights can be dropped. This light will work for 20 years.

SPENCER MICHELS: But some experts say there are serious issues that need to be addressed when exporting such technology.

ASHOK GADGIL, environmental engineer, Lawrence Berkeley National Laboratory: Developing countries are a graveyard of well-intentioned technologies from the First World.

SPENCER MICHELS: Environmental engineer Ashok Gadgil has been consulting with WE CARE Solar. He developed the Darfur Stove that has revolutionized cooking in the developing world. And he's a senior scientist at the Lawrence Berkeley National Laboratory.

He says he's impressed with what he's seen so far, but he says if Stachel and Aronson are to succeed, they must address how the system will be maintained over the long term.

ASHOK GADGIL: No single technology, no single piece of machinery has infinite life. When one wants to introduce a technology into society, it needs social placement. The technology needs links and threads that connect it to a Web of experts or spare parts dealers or maintenance people or diagnostic technicians which will keep it going.

SPENCER MICHELS: How do you know that, after a year, this thing isn't going to get rusted or break or whatever?

HAL ARONSON: That is a major concern of ours. So what we've done is we have chosen the best-quality components. The battery technology is our main area for improvement. So this is a standard sealed lead acid battery. And it should last a couple of years. The rest of the system is designed to last 10 to 20 years. We would love a battery that could hold up for five or 10 years.

SPENCER MICHELS: Initially, assembling the suitcases one by one in their backyard with the help of friends and volunteers, they are now working with a nearby manufacturing plant to produce 30 a month, still a far cry from the massive worldwide need.

They admit that their small-scale operation must ramp up. For now, private donations and several foundations are supporting their efforts. They want to eventually lower the cost of the suitcase and enable it to power other medical tools, such as a suction device.

But getting the Solar Suitcase into dark delivery rooms is Stachel's first priority.

DR. LAURA STACHEL: I think it's an outrage that women in other countries suffer 100-fold higher risk of dying in childbirth than women in this country.

So it's really important to me that the most vulnerable populations, which are women, childbearing women and their newborns, that they're at the front of the line. But it doesn't mean that other populations aren't important as well. Schools have asked for these, community centers, orphanages, refugee camps. So we think that we're really just sitting on the tip of an iceberg.

SPENCER MICHELS: Stachel and Aronson are looking to up the production of Solar Suitcases to meet the demand. And now they're getting cooperation from the World Health Organization, which is helping them to study the impact of the new technology.

JUDY WOODRUFF: Watch more of Spencer's interview with Dr. Stachel and see images of the Solar Suitcase in action in Africa and Afghanistan. Our slide show is on the Rundown online.

Saving Lives With Solar Power

Wed, 04 Apr 2012 16:00:00 EDT

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What's as easy as lighting up a room -- say a hospital delivery room? You'd be surprised.

In much of Africa and other poor areas, electricity is scarce and unreliable. Hospitals and clinics in developing countries often use flashlights or kerosene lamps, which are inadequate or pollute the air. Doctors or midwives may not be able to see what they're doing if a woman goes into labor during nighttime hours, and it could be nearly impossible for health care workers to save the mother's or baby's life if there are any complications during the delivery. Darkness makes medical care a huge gamble -- a gamble that is often lost. It also forces many clinics or hospitals to close at night.

Estimates say 300,000 health clinics worldwide don't have reliable electricity and therefore don't have reliable lighting once darkness falls. It seems such a simple problem, but of course it is not.

A few years ago, Laura Stachel, an OB-GYN based in Berkeley, Calif., traveled to Northern Nigeria to study why so many women were dying in childbirth. She was shocked.

"What I saw were some of the sickest patients I'd ever seen in my life -- probably more complications than I'd seen in my entire career," she said. "Yet the hospital did not have a reliable source of electricity. I watched (cesarean sections) where the lights would go out and the doctors literally finished with my own flashlight."

Stachel, who had stopped delivering babies because of a back injury, emailed her husband, Hal Aronson, who knew a bit about solar electricity. She asked him to tinker with a solar solution to the clinics' electricity problem. He went to work designing a simple suitcase filled with solar panels, a battery, LED lights and plugs that could be set up in a remote clinic. The solar panels would convert sunlight to electricity, which would be stored in the battery. The battery would then power the LED lights illuminating the delivery room.

After a lot of experimentation, the solar suitcase worked. Stachel could bring the suitcases to remote hospitals and clinics across the developing world. After installation in one hospital, maternal deaths decreased by 70 percent. "And they were no longer turning away patients at night, so their ability to see patients increased by about 16 percent," Stachel said.

Stachel and Aronson set up the nonprofit We Care Solar and started making and improving the solar suitcase. The suitcase mostly consists of off-the-shelf technology -- lights, batteries and cords available at most hardware stores. Some elements were made specifically for the project, such as specially sized solar panels and an almost indestructible light. As development continued, the suitcase became more efficient and easier to operate. But with 300,000 clinics experiencing the darkness problem, the few suitcases Stachel and Aronson could produce seemed like a drop in the bucket.

Now they're turning to others for advice and support. We Care Solar is working with Lawrence Berkeley National Laboratory's Ashok Gadgil, an environmental engineer who invented the revolutionary Darfur stove, which is used in many developing countries. Gadgil advised We Care Solar to treat their suitcase technology differently than you'd take care of a car. "We assume that there is a mechanic -- there is a guy who will inflate your tires," Gadgil said. "There is somebody who will tune it up. He'll find spare parts. He'll find a gasoline infrastructure. You'll find roads that are paved and maintained. That's how we assume it."

But when those things are absent, the car -- or the solar technology -- must have a backup, Gadgil said. And those elements are often absent for the solar-light setup Aronson and Stachel developed.

"No single technology, no single piece of machinery has infinite life. It's going to fail," Gadgil said. "And what we need ... is a backup system that would pay attention to diagnostics, placement and assessment -- or just get a new suitcase." In other words, be ready to replace parts in an area where there is no Home Depot, no Fed Ex, no electricity grid.

In addition, We Care Solar must figure out how to boost its production from 160 suitcases -- the current number -- to the 300,000 or more that Stachel believes are needed around the world. And she'd like to get the cost of the suitcase down from $1,500 to less than $1,000. The nonprofit is looking for partners, donors and groups such as the World Health Organization to help them scale up. WHO has already indicated interest in the project and is helping with a study of the technology in Liberia.

Despite the challenges, Stachel and Aronson have come a long way. Now, they realize, they still have a long way to go.

Watch Spencer's broadcast report on this subject:

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Solar Suitcase: Saving Lives with Solar Power

Wed, 04 Apr 2012 12:55:00 EDT

Dr. Laura Stachel and her husband founded We Care Solar to help bring light to the estimated 300,000 hospitals and clinics in the developing world that don't have reliable sources of electricity. Our slideshow highlights Stachel's work toward equipping remote clinics with solar suitcases that bring light to dark delivery rooms.

Food for 9 Billion: Business Fund Puts African Farmers on Road to Market

Tue, 03 Apr 2012 18:34:00 EDT

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In Kenya, Rwanda and Burundi, a new approach to small-scale farming has spread to more than 100,000 families in just four years. Part of the Food for 9 Billion series, Fred de Sam Lazaro reports on an organization called One Acre Fund that brings struggling farmers together, offering them training, resources and market access.

GWEN IFILL: Next, bringing business services to small-scale farmers in East Africa. Our story is part of a series called Food for 9 Billion. It's a partnership with the Center for Investigative Reporting, American Public Media's Marketplace, and Homelands Productions.

Special correspondent Fred de Sam Lazaro reports.

FRED DE SAM LAZARO: Andrew Youn was almost done with business school in 2005 when he took a brief vacation to Kenya. It was the Minnesota native's first exposure to the irony of life for millions of people in rural Africa.

ANDREW YOUN, founder, One Acre Fund: The shocking thing and kind of an amazing paradox is that most of the world's hungry people are actually farmers and their profession is to grow food. And the reason they're not succeeding right now is they're still using tools and techniques that literally date to the Bronze Age.

FRED DE SAM LAZARO: He decided to apply his new MBA skills to see if he could help. He began with a pilot project to assist 40 families.

I took $7,000 of my own savings and bought seed and fertilizer and hired some local staff. And we gave it a shot. The families just kind of signed up. And they were also interested. And they had the best harvest of their entire lives in that first season. And right when that happened, I knew that there was something there.

FRED DE SAM LAZARO: His project turned into One Acre Fund, named after the small size of most African subsistence farms. Six years later, a staff of more than 800 serves over 125,000 farm families in Kenya, Rwanda and Burundi.

ANDREW YOUN: If you look at those bales of seed, for example, that stack of bales is enough to change the lives of thousands of farm families with, you know, like more than 10,000 children living in those families.

The sheer magnitude of what we can accomplish from a humanitarian perspective with very little resources is just staggering.

FRED DE SAM LAZARO: But One Acre Fund isn't a typical humanitarian service. It offers a business model. One Acre gives the smallest of farmers the same services available to the biggest of businesses, credit, seed, insurance and access to markets.

It's called the market bundle. One Acre Fund also offers training, how to space plants, when to apply fertilizer and how much. It's not rocket science, but the results are impressive.

I'm standing in a spot that illustrates the difference One Acre Fund can make. Over my left shoulder is a pretty typical small holder farm where you'll find a cluster of pretty randomly planted cornstalks. But walk just a few feet to that farmer's neighbor, and you will find a One Acre Fund member. And this farmer's seeds are of better quality. They've been planted in careful rows. And you can tell by the quality of the stalks and the sheer density of this plot that the yield here is going to be much higher.

Better harvests begin with better seeds and fertilizer that the farmers get at a discount.

ANDREW YOUN: The individual small holder farmer is about the least powerful person on the planet, you can imagine. But when we aggregate 100,000 of them or more together, then we get a lot of purchasing power and we can get them a good deal, we can deliver, we can add a lot of value to them.

FRED DE SAM LAZARO: But, even with a good deal, cash is hard to come by here, especially at the start of the season. So instead of making the farmers pay up front, One Acre Fund gives them loans for the seeds and fertilizer they need, loans that are insured.

ANDREW YOUN: Poor people are of the worst suited people in the world to have risk in their lives. They're already living on the margin. And having a bad harvest, for example, and bad weather basically means it could be as severe as a child or even two dying. So, rain insurance is a standard part of our package. And so if the rain doesn't fall, they don't pay.

Another risk is death. We have what we call funeral insurance.

FRED DE SAM LAZARO: The loans must be repaid at harvest time. But most farmers begin paying their installments well in advance. The default rate is less than 1 percent.

ANDREW YOUN: Wow. Congratulations.

So, this lady was saying that she was getting a milk cow. And she's selling now, earning about $2, $2 a day from that milk cow.

FRED DE SAM LAZARO: In Rwanda, Agriculture Minister Agnes Kalibata likes the fact that even though One Acre Fund is a nonprofit, it works with farmers as business partners.

AGNES KALIBATA, Rwandan agriculture minister: There's always a sense of dependency. When they're offering the private sector, there's a sense of -- it's a give-and-take. So, One Acre Fund brings that on the table.

FRED DE SAM LAZARO: The approach is showing results. On average, farmers enrolled in One Acre Fund have seen their crop yields triple.

Joyce and Maurice Soita have done much better than average.

JOYCE SOITA, One Acre Fund farmer: For now, we have 18, but. . .

FRED DE SAM LAZARO: Before.

JOYCE SOITA: . . . before, two or three bags.

FRED DE SAM LAZARO: So, before, you used to get two or three bags of maize from your land, and now you get 18 last year.

JOYCE SOITA: Eighteen, yes.

FRED DE SAM LAZARO: The Soitas took me to see the investments they have made with their profits, school for their four daughters, about 160 U.S. dollars per year.

JOYCE SOITA: My first kid, she say that she wants to be a doctor. Then I told her, keep up.

(LAUGHTER)

FRED DE SAM LAZARO: Keep up. Yes, keep up that ambition.

JOYCE SOITA: Yes.

ANDREW YOUN: Our farmers go from subsistence to finally getting enough food for their entire families, but then also selling surplus for the first times in their lives.

FRED DE SAM LAZARO: And Youn says this is opening up new opportunities for farmers.

Richard Sitati has been a One Acre Fund farmer for three years. He not only has surplus food staples like maize, but also grows crops for cash: peanuts and bananas. In the old days, Sitati had to rely on middlemen in his local market here in Twele for everything: buying seeds, selling the occasional surplus, with little bargaining power.

Now he visits a new kind of stall in the market. It sells information. Bananas, he learned, were fetching much higher prices in El Dorat, a town about 100 miles away.

RICHARD SITATI, One Acre Fund Farmer: So, here, I found out, when you look at the bananas, in Twele it's 280.

FRED DE SAM LAZARO: Yes. Yes.

RICHARD SITATI: But when you go to El Dorat, it's about 400.

FRED DE SAM LAZARO: So you can look at this board here and determine where the best place is to sell?

RICHARD SITATI: Yes. Yes. Yes.

FRED DE SAM LAZARO: A new for-profit company called KACE has set up outlets like this one in markets across Kenya. The Internet and cell phone connections inform the trading boards and link producers like Sitati with distant buyers.

KACE was started by an Adrian Mukhebi, an economist trained at the University of Kansas. Mukhebi says the centers faced resistance when they first opened.

ADRIAN MUKHEBI, founder, Kenya Agricultural Commodity Exchange: Middlemen and traders didn't like them. They opposed them. Why? Because we were providing information to the farmers. We were empowering the farmer to know the market prices and increase the farmers' bargaining power.

FRED DE SAM LAZARO: Now he says, even though middlemen get a smaller share of the pie, the pie has gotten much larger.

For farmers, getting the best price is also a question of timing. Soon after a harvest, there's plenty of maize, so the price plummets. One Acre staffers, most of them just out of college, are working on a pilot project that would offer loans for farmers to store some of their grain.

MAN: A farmer normally is selling their maize in January. We wanted, just basically, instead of them selling their maize, have it put right back in their house and then pay that school fee.

ANDREW YOUN: The farmer would be very tempted to sell their harvest almost immediately, so they could pay for school fees. But really they ought to be holding onto that harvest for about six months, when it's much more valuable and scarcer in the hunger season.

FRED DE SAM LAZARO: So they'd get a better price for it.

ANDREW YOUN: Exactly.

MAN: If we can help our farmers store their maize for longer, then we can help them make a lot more money.

FRED DE SAM LAZARO: One Acre Fund took in $5 million in farmer loan revenue last year, but still needed a million dollars in grants and donations to cover their expenses.

They say their Kenya and Rwanda operations should break even in a few years. But sustainability also depends on the investments that governments will make, from building new roads to improving storage facilities and seed and fertilizer supply.

At the Alliance for a Green Revolution in Africa, Margaret Kroma says the government support is critical for groups like One Acre Fund to succeed.

MARGARET KROMA, Alliance for a Green Revolution in Africa: Otherwise, we can have beautiful, wonderful islands of excellent work that just fades away over time. How do you make that ultimate connection between the technology that works in smaller assistance and the larger policy environment, the institutions that will ensure that these innovations continue to be scaled up and scaled out?

FRED DE SAM LAZARO: Andrew Youn agrees. But for now, the program's success is built on the farmers' success, one acre at a time.

ANDREW YOUN: It's really wonderful to see. People really do invest every dollar they finally gain and start building kind of like a staircase to a better life.

FRED DE SAM LAZARO: Youn predicts One Acre Fund will exceed its goal to serve 1.5 million farm families by 2020, a 15-fold increase from today, but still a fraction of the 40 million families that he says could use help across Africa.

JUDY WOODRUFF: Fred's reporting is a partnership with the Under-Told Stories Project at Saint Mary's University in Minnesota.

A radio report on Brazil's efforts to eliminate hunger throughout the country airs tomorrow on American Public Media's Marketplace. You can watch our first three reports at the Food for 9 Billion website. You can find a link on our site.

Doctor's World Bank Nomination Signals Renewed Development Focus

Fri, 23 Mar 2012 18:10:00 EDT

President Obama, right, introduces Jim Yong Kim as the nominee to become World Bank president at the White House on Friday. Photo by Andrew Harrer/Bloomberg via Getty Images

President Obama announced the nomination of Dr. Jim Yong Kim, a physician and the president of Dartmouth College, to the presidency of the World Bank on Friday. If confirmed, Kim would succeed Robert Zoellick as the leader of this important lending institution based in Washington, D.C. The nod must come as a surprise to bank watchers around the world. Kim's name had not appeared on any short lists circulating in the media in the weeks leading up to the appointment deadline.

Kim would succeed a long line of economists and career government employees at the helm of the World Bank, which was created in the waning days of the WWII to begin the rebuilding of a ravaged world.

So, why not a central banker? Why not a career economist? Why not a conventional "green eyeshade" guy or gal to run the place? Zoellick's tenure at the bank capped a long economics career in and out of government service: Treasury Department deputy assistant secretary for Financial Institution Policy, executive vice president of Fannie Mae, U.S. trade representative.

A closer look at the bank and at Kim reveals a strong internal logic to the appointment. No one in Washington has a mortgage or Christmas club account at the World Bank. There are no teller windows, no ATMs and no toaster ovens for transferring from another bank. More than anything else, the World Bank is a source of loans for developing countries.

The World Bank includes five agencies, including the International Development Agency, which gives interest-free loans and grants to governments of the poorest countries; the International Finance Corporation, which encourages investment and technical assistance from the private sector to developing countries; and the International Bank for Reconstruction and Development, which makes loans to middle-income countries and a small number of creditworthy poorer states.

Considering the bank's role as an international economic development agency, the selection of Kim over, for example, former Treasury Secretary Lawrence Summers, starts to make more sense. Kim is a co-founder and former executive director of Partners in Health, which has grown from its focus on rural Haiti to implementing programs across the world's poorest countries aimed at improving basic health services. The Harvard-education physician served two years as head of the World Health Organization's HIV/AIDS department and has been an international leader in anti-tuberculosis policy. Kim is also a co-founder of the Global Health Delivery Project, which seeks to build new systems for providing basic health services to populations in poverty.

It may turn out that his earlier experience may serve him better at the World Bank than it has at Dartmouth. He arrived at the Ivy League campus in New Hampshire as the school was reeling from the loss of portfolio value following the collapse of the stock market. Since the shrinking endowment was the source of almost a quarter of the school's operating budget, immediate and sizable budget cuts of $100 million over two years were required from the moment Kim took office. There followed disputes with faculty, students, and alumni over priorities, governance, alcohol use, assaults and Greek life on campus. It would have been a tough 2 1/2 years for anyone, but it was a particular challenge for a new leader in the spotlight: Kim was the first Asian American to lead an Ivy League school.

When Zoellick announced he would be leaving the World Bank, a season of hot speculation and open campaigning for the departing president's seat began. Though Americans have led the World Bank since it was established, candidates from what's often called the Global South attracted attention: Nigerian Finance Minister Ngozi Okonjo-Iweala and former Colombian Finance Minister Jose Antonio Ocampo. Jeffrey Sachs of the Earth Institute at Columbia University attracted strong attention in the U.S. and was supported by political progressives as an alternative to rumored candidates such as Summers. Troubles that began in the U.S. pushed the world economy to a precipice in 2008, so the appeal of a new president from somewhere else in the world was growing.

Kim was born in South Korea and came to the U.S. as a boy. His time at Dartmouth has attracted intense attention and favorable media coverage in South Korea. Kim's immigrant journey may blunt some of the criticism expected of yet another American nominee to the influential post. In his announcement of the appointment, Mr. Obama said:

(Kim's) worked from Asia to Africa to the Americas, from capitals to small villages. His personal story exemplifies the fact that anyone can make it as far as he has as long as they're willing to work hard and look out for others. And his experience makes him ideally suited to forge partnerships all around the world.

Kim's status as an experienced hand in public health, disease prevention, and raising the skills and self-sufficiency in developing countries mirrors changes at the World Bank itself in recent decades. It will be interesting to see whether a medical doctor can continue the challenging work of creating a better image for the bank in the rest of the world as well as putting more than $40 billion a year in lending on sound economic footing.

For a long time, the institution was cast as an international villain -- doing business with undemocratic regimes, funding huge and destructive white elephant projects, and causing environmental havoc in Asia, Africa, and Latin America. The World Bank, and its Washington-area neighbor the International Monetary Fund, have stepped away from showy marquee projects such as hydroelectric dams. Instead, they have concentrated on projects more likely to change the life circumstances of common people in poor countries. Along with better investment, the World Bank has put more focus on representative, responsive and accountable government in the countries where it lends.

Partners in Health, meanwhile, insists doctors and technocrats from wealthy countries cannot parachute in to a poor country and start giving aid on the condition that they give the orders. The organization co-founded with Dr. Paul Farmer and others has always stressed listening to hospital administrators, health ministers and doctors in the developing world rather than telling them what to do. That's not too far from what you hear around the World Bank.

The bank still has its critics and detractors, and countries around the world still groan under the weight of debt incurred in previous decades through ill-conceived borrowing. Kim, too, will have his critics -- both for insufficient experience in lending and financing capital projects in the developing world and from his time at Dartmouth. However, with voting for the new president weighted by contributions to the World Bank, the U.S. government's backing of Kim makes him a prohibitive favorite in the coming balloting. The appointment of a public health professional may represent the final installment in a decades-long transition for the World Bank.

What's Causing Water Shortages in Ghana, Nigeria?

Thu, 15 Mar 2012 18:29:00 EDT

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Two journalists investigate the challenges of bringing the most basic necessity to the people of Ghana and Nigeria: clean, safe water. As part of a collaboration with the Pulitzer Center on Crisis Reporting, special correspondent Steve Sapienza followed them as they searched for what's causing the water shortages.

JUDY WOODRUFF: Next tonight, from West Africa, a look at the challenges of getting the most basic resource, water, to people who need it.

Special correspondent Steve Sapienza partnered with investigative journalists in two nations, Ghana and Nigeria, as they searched for what's behind the water shortages.

His story is part of a collaboration with the Pulitzer Center on Crisis Reporting.

STEVE SAPIENZA: Every day, millions of people across a wide swathe of West Africa struggle to get access to clean and safe drinking water. The World Health Organization estimates that more than 1,000 people in the region die each day from illnesses related to unsafe water.

The shortage is also hampering development here. In two of the biggest and richest nations of the region, Nigeria and Ghana, pollution, political unrest, and corruption have contributed to water shortages for decades.

What's different today is that a new generation of West African journalists is trying to hold government officials accountable for the failures. We followed two of them, Nigeria's Ameto Akpe and Ghana's Samuel Agyemang, as they did their jobs.

As a reporter for Nigeria's BusinessDay newspaper, Ameto's stories target the contradiction of a country with immense oil wealth and great water resources that are not reaching their citizens.

We met in Abuja and traveled six hours by car to Makurdi, the capital of Benue State in north-central Nigeria.

AMETO AKPE, BusinessDay: The river Benue, which is one of the major rivers of Nigeria, runs through this town. The town sits on the banks of this major resource. However, the town brings to life a common proverb, which says, you sit by the riverside, yet you wash your hands with spittle.

STEVE SAPIENZA: Ameto chose to focus her reporting here on the Greater Makurdi Water Works project. It's the latest government attempt to expand delivery of treated water from the Benue River to 600,000 residents, the majority of whom have waited decades to receive water from city pipes.

The previous attempt to build a water treatment plant ended in scandal in 2008, with an unfinished treatment facility and city officials unable to account for $6 million. This failure impacts hundreds of thousands of residents outside the reach of the city's old pipe network, who now pay high prices for water delivery from tanker trucks or water pump operators. And those who can't afford water delivery collect untreated water from the Benue River.

AMETO AKPE: I visited here, and I was shocked by what I saw. People were actually scooping water from the Benue River, which is massively polluted. And there are several occurrences every year of people dying of cholera, falling terribly sick from dysentery, typhoid fever.

STEVE SAPIENZA: The water minister of Benue State says the remedy is finishing the Greater Makurdi Water Works.

AMETO AKPE: So, in other words, this is an answer to the problem of water?

JOHN NGBEDE, commissioner of water resources: This is the answer to the problems of water in Makurdi. Now that we have built the water works, this water has to be sent out to the people.

STEVE SAPIENZA: But to do that, Makurdi needs a larger pipe network, and one that is in good condition.

NAT APIR, independent water consultant: These pipes have corroded, and so they cannot withstand any pressure of water coming out of the new treatment plant. So you will have them busting all over the place.

STEVE SAPIENZA: Former Coca-Cola executive Nat Apir is now an independent water engineer. He says the new water treatment plant will produce enough water, but it will have nowhere to go.

NAT APIR: The coverage of the pipes that were laid about 30 years ago is just about 25 to 30 percent of the metropolis and its environs, hence the need to lay new pipe networks.

STEVE SAPIENZA: Facing public criticism about the pipes, the government has asked contractors to submit proposals to expand the pipe network.

AMETO AKPE: And is there any time frame? Because people are waiting, people are expectant.

JOHN NGBEDE: No, but don't worry, don't worry. In the next six months, 12 months -- it's far. We are expecting that by the time we start pumping the water out. . .

AMETO AKPE: Experts say it may blow and. . .

JOHN NGBEDE: Pipes busting? I want to see that. I want to see that.

AMETO AKPE: You want to see that before you intervene?

It brings to mind an occurrence which -- in the early '90s in another locality very close to Makurdi, this great water project was commissioned. However, the day it was test-run, the whole city was -- the whole town was flooded because the pipes busted, because some people say faulty technical work.

STEVE SAPIENZA: In the neighboring country of Ghana, residents of the capital, Accra, are frustrated with the government's failure to provide a reliable supply of piped fresh water, this despite Ghana's ample water resources and a steady flow of foreign aid for water projects.

About four years ago, when Accra was experiencing severe water shortages, the public named these containers Kufuor gallons after the sitting president. Now reporter Samuel Agyemang is asking why these containers are still found in area neighborhoods.

Samuel Agyemang is an award-winning reporter who anchors the national evening news for Metro TV.

SAMUEL AGYEMANG, Metro TV: Hello. Good evening. And welcome to the weekend news.

STEVE SAPIENZA: His investigation into illegal nighttime water tapping led him to pursue the much bigger problem of gaps in water access citywide. The story starts right in his own backyard, the seaside enclave known as Teshie.

SAMUEL AGYEMANG: Teshie is about -- has a very huge population, close to 200,000, very diverse as well. It has a very poor community, has the middle-income folks, and then it also has the extreme rich.

STEVE SAPIENZA: Samuel's neighborhood is fairly new and receives water from a city pipeline. The water supply is erratic, however, because the city has not kept up with the water demand of all the households and businesses in this growing city of nearly two million people.

SAMUEL AGYEMANG: Any time we get the water, like on Saturdays and Sundays, I store some of them in these bottles, and then I'm able to boil them any time I want to use them to cook or to drink.

And this is also another bucket where I have water in there. You can see it inside, so I can get like just a bucket or two of these, and then I use them to bathe in my bathroom.

STEVE SAPIENZA: A short drive from Samuel's home sits the poorer, ramshackle seaside areas of Teshie.

When Samuel arrives, residents crowded around a newly-installed water tap outside a private home tell him they have waited 15 years for piped water. That meant walking to the nearest fresh water supply with buckets.

SAMUEL AGYEMANG: If you want to walk, it would you about how many minutes?

BOY: About one hour.

SAMUEL AGYEMANG: About one hour to get water, before you get water to bathe and go to school.

STEVE SAPIENZA: City taps that were once a faint promise are now a source of fresh income in this part of Teshie. Those lucky enough to have a tap on their property charge a small fee to their neighbors for a bucket of water.

Still, most of this community remains underserved by the Ghana Water Company, a state-run entity that Samuel discovered has been more successful at raking in foreign investment dollars than supplying water.

KWEKU BOTWE, Ghana Water Company: We are attracting a lot of investment like nobody's business.

SAMUEL AGYEMANG: How do we close those gaps, you know, considering the sort of investments that we are attracting like nobody's business?

KWEKU BOTWE: There's a lot of -- there's a lot of work being done. There are a lot of projects that are ongoing which can be delivered in the next two, three, four years.

SAMUEL AGYEMANG: So what happens to a community like Teshie, which has been in existence for a long, long time, one of very -- very traditional, but hasn't had water for 20 years?

KWEKU BOTWE: It is not true.

STEVE SAPIENZA: The reality on the ground is otherwise. Samuel says the problem is, officials are not accountable to the underserved communities.

SAMUEL AGYEMANG: You know, you go around talking to people that we have spent a night with, people we have spent days with struggling for water, and these people don't have any sense of what the money is being used for, the taxpayers' money. They don't understand what project is supposed to come to them. They don't see anybody to hold accountable and ask, why am I not getting water?

STEVE SAPIENZA: According to a 2010 study by the World Health Organization and UNICEF, $8 out of every $10 in the water sector budget here are from foreign donors, who are not interested in building water pipelines in Accra.

Alban Bagbin is the minister of water, resources, works, and housing.

ALBAN BAGBIN, Minister of Water, Resources, Works, and Housing: Many of our development partners are interested in developing treatment plants, and not in supporting the expansion of the distribution network.

STEVE SAPIENZA: Nonetheless, Minister Bagbin predicts the country will reach 100 percent coverage by 2025.

One would only hope that, with confession and admission of the fact that investments are going to be -- are coming into the water sector, authorities will -- would make sure that in the very shortest possible time, we get 100 percent coverage of water supply.

STEVE SAPIENZA: Faced with the daily struggle to conserve water at home, reporter Samuel Agyemang has vowed to keep up the pressure on authorities until he and everyone living in neighborhoods across Accra have access to safe, clean water 24 hours a day, seven days a week.

JEFFREY BROWN: On Friday, Nigeria's president officially commissioned the Makurdi Water Works. But according to journalist Ameto Akpe, there's been no change in water quality or supply for local residents because a pipe network remains to be built.

'The Worst Place on Earth to Be a Woman': Healing the Eastern Congo

Wed, 07 Mar 2012 18:31:00 EDT

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The Democratic Republic of Congo is the worst place on earth to be a woman, according to the United Nations. Regional war and rape leave an estimated 1,000 or more women assaulted every day. One organization, HEAL Africa, helps women manage their traumatic injuries holistically. Correspondent Fred de Sam Lazaro reports.

GWEN IFILL: Now a look at one organization's holistic approach to healing the wounds of war.

Special correspondent Fred de Sam Lazaro reports from Goma in the Democratic Republic of Congo.

A version of this segment aired on PBS' "Religion & Ethics Newsweekly."

FRED DE SAM LAZARO: The United Nations says the Democratic Republic of Congo is the worst place on earth to be a woman.

For two decades, regional militias have clashed over the minerals here. One of the weapons of war, rape, continues, despite peace agreements and elections. By one estimate, more than 1,000 women are assaulted every day. By another, the problem has hit some 12 percent of Congolese women.

One of the few places women can turn is HEAL Africa in the eastern city of Goma. Here, women work to shake off atrocities they have faced, to deal with their traumatic injuries. This woman wears a mask to conceal her maiming at the hands of militiamen who raided her home one night in 2010.

ANNONCIATA, Congo (through translator): My older daughter escaped from them. They told me to go get her. And I said, she's escaped from you. How could I ever catch her? Since I wouldn't give them my daughter, they hit me in the head with a machete. And after I fell down, they used that same machete to cut off my lips.

FRED DE SAM LAZARO: A volunteer health worker brought her here. HEAL Africa was started 12 years ago by British-born Lyn Lusi and her Congolese husband, Dr. Jo Lusi, devout Christians who'd served for years before that as medical missionaries.

LYN LUSI, co-founder, HEAL Africa: HEAL is an acronym. It stands for health, education, action in the community and leadership development, and all of those are components of a healthy society.

FRED DE SAM LAZARO: The facilities are spartan, but they offer the only such services to a population of eight million.

HEAL Africa survives on about $13 million a year in grants from abroad, public and private, providing everything from antiretroviral drugs to hundreds of children with HIV, to surgery to repair the bodies of traumatized women.

Dr. Jo Lusi is the only orthopedic surgeon in Eastern Congo, but he says this work is part of a larger idea.

DR. JO LUSI, co-founder, HEAL Africa: When you serve a human, I don't see you here like a human. I see you like an image of God.

So to do that, you have to be holistic. You have to be total. You have to know a lot about the spirit, about the flesh, about the soul. Here, people are lacking everything. They don't have food, absolute poverty. They are exploited. They are perishing because of the lack of knowledge. They are perishing because of the lack of justice. So me and my wife said, OK, how do you do a holistic system?

FRED DE SAM LAZARO: HEAL Africa has trained 30 young Congolese doctors and many other health workers. But the Lusis say their holistic approach goes well beyond surgery to help rebuild women's lives.

At this shelter, women spend months, even years recovering from rape injuries. They're taught to sew, make baskets and raise small animals.

Basenya Bandora even allows herself to dream.

BASENYA BANDORA, Congo (through translator): I want to have a little shop, and I will make bread and I will sit there with my sewing machine, and people will bring me things to sew. I will make baskets. If I can have a little house, that would be very nice.

FRED DE SAM LAZARO: For now, for practical purposes, such dreams are pure fantasy. These women have lingering health problems. And militiamen continue to raid villages with impunity.

Annonciata frequently sees the men who maimed her, but reacted viscerally to a suggestion she might report them to the police.

ANNONCIATA (through translator): I'm terrified. They would kill me. Only God can punish them for what they did.

FRED DE SAM LAZARO: But HEAL Africa has begun working to bring a more immediate justice for victims of rape.

In partnership with the American Bar Association, local lawyers work to apprehend suspects and put them through the legal system here. It is flawed and corrupt, but Lyn Lusi says only when Congolese begin to buy into it will it begin to work for them.

LYN LUSI: I would always encourage our legal aid to work 10 times more on the issue of bringing the community in line with the law, so that they appreciate what the law is trying to do, and that they agree with it, and that there's social pressure, there's a -- there's a desire within the community for zero tolerance of sexual violence, of any sort of violence.

FRED DE SAM LAZARO: That's what brought this 15-year-old girl and her father to the legal clinic to bring charges against a young man who raped her while she went to collect water for the family.

PATRICE KIHUJHO, parent of rape victim (through translator): I want him not only to be put in prison, but also to pay for the damages he caused.

Last year, I turned 75 years old. When we were growing up, we never saw this kind of behavior. When you liked a girl, we would get married. I am really astonished. I'm not sure what's going on, how they can take little girls and assault them.

FRED DE SAM LAZARO: Lyn Lusi thinks its a consequence of fighting that has raged for two decades in Eastern Congo, destroying any sense of community.

LYN LUSI: You have seen your village destroyed. You've seen your people killed, and you're a young man with no future. I mean, you have every reason to fight and every reason to go off and join the militias.

There are also those militias that will kidnap children and take them into their armies just to reinforce their ranks. Children are extremely good soldiers, in that they have no fear and they have no conscience.

FRED DE SAM LAZARO: Where does one begin to repair this?

The Lusis say they've worked to tap the enduring faith of most Congolese.

LYN LUSI: Here is a mandate to care that's in the Muslim community, that's in the Christian community, and it's present in every single locality in Congo.

You could say that probably 95 percent of Congolese will go to a place of worship once a month, at least. So this is an amazing power within the community. And if we knew how to mobilize people correctly around their mandate to care, then you can make a big impact on a social problem.

FRED DE SAM LAZARO: HEAL Africa has gathered religious leaders and other elders into so-called Nehemiah committees. These gatherings address sources of violence early on, mediating local business disputes or competing land claims before they escalate.

Lyn Lusi says it's a start.

LYN LUSI: I have no illusions that we're dealing with major issues that are pulling Congo apart.

There is so much evil and so much cruelty, so much selfishness, and it is like darkness. But if we can bring in some light, the darkness will not overcome the light, and that's where faith is, if you believe that.

I don't think HEAL Africa is going to empty the ocean, but we can take out a bucketful here and a bucketful there.

FRED DE SAM LAZARO: Her efforts received a hefty boost recently, when Lusi was awarded the 2011 Opus Prize, a $1 million award given by the Minnesota-based Opus Foundation to a faith-driven social entrepreneur.

JUDY WOODRUFF: Fred's reporting is a partnership with the Under-Told Stories Project at Saint Mary's University in Minnesota.

Anonciata's Story: Seeking Healing After Congo's Brutal Civil War

Wed, 07 Mar 2012 17:30:00 EDT

Photo of Anonciata by Fred de Sam Lazaro for the PBS NewsHour.

Few nations are more endowed with mineral resources than the Democratic Republic of Congo and none has endured a more staggering human cost in the scramble for these riches. The death toll from two decades of civil war -- 5 million -- is second in recent history only to the Holocaust.

But what's it like to survive?

Our recent visit to the eastern city of Goma offered a fleeting glimpse of what the United Nations has called the worst place on earth to be a woman. Consider: one of every 10 Congolese women is a victim of rape.

The facilities of HEAL Africa, an aptly, if optimistically, named non-government group is one of the few places women can go for refuge. Here, we ran into a 30-something mother of four named Anonciata, who interrupted a brief tour I was getting from the medical director to plead her case for more surgery.

In 2010, Anonciata's home was invaded by militiamen, demanding that she track down and hand over her teenaged daughter, who fled as the men approached. Unhappy that she wouldn't comply, the men beat her to the floor. One of them used a machete to amputate her lips.

Oblivious to our rolling cameras, Anonciata took off the mask that covers her face from the nose down, seizing the unexpected opportunity to consult-mostly plead-with the doctor. In video is too graphic to broadcast or post, out came a litany that's as familiar to her caregivers as it seems futile. She was feeling pain and, unable to chew, restricted to a fluid diet. She is the first person I've ever met who suffers from what the doctors call oral incontinence. The cloth surgical mask is all she has to catch the steady drip of saliva.

Rebuilding her wounds will take extensive surgery, available about once a year when a plastic surgeon visits these facilities. When he was here last, in September, Anonciata had gone to her village and could not be located. Like many others she must wait for his return. Like everyone else, she must reconcile with the limits of Congo's reality. She may undergo surgery to rebuild her face. She likely will never receive justice.

Anonciata frequently sees the men who maimed her but would never think to report them to authorities. The very thought of the consequences makes her shiver. "They would kill me," she said.

Amid all this HEAL Africa, moving well beyond the medical imperative that drove its foundation, is pursuing some rape cases; trying help push the embryonic judicial system to deliver, transparently. There are so-called Nehemiah committees, which gather community elders to work locally to contain disputes before they escalate into violence. It is central to the holistic approach and deep Christian faith of the organization's founders, British-born Lyn Lusi and her Congolese husband, Jo. He's not the most prolific orthopedic surgeon in all of war-torn eastern Congo, he is the only one, serving a population of 8 million.

"Human beings are basically very, very selfish creatures. And if it goes unchecked it turns into evil," says Lyn Lusi.

"There is so much evil and so much cruelty, so much selfishness and uh it is like darkness. But if we can bring in some light, the darkness will not overcome the light and that's where faith is, we believe that."

The Lusis too must reconcile with limits, taking out "a bucketful here and a bucketful there" out of an ocean of need.

View Fred de Sam Lazaro's report from the Democratic Republic of Congo on Wednesday's NewsHour.

Hans Rosling Brings Life, Humor, Sword-Swallowing to Global Health Statistics

Mon, 05 Mar 2012 18:39:00 EDT

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Hans Rosling, co-founder of the Gapminder Foundation, visualizes global health trends and population numbers -- transforming dry poverty and development statistics into Internet sensations. In addition to his focus on the developing world and data visualization, the Swede happens to swallow swords. Ray Suarez reports.

GWEN IFILL: Now, the man who turned global health and population numbers into an Internet sensation.

Ray Suarez has that story.

RAY SUAREZ: Amid the glitter of a black-tie fund-raiser in New York City, a downright un-glittery guest made his way into the room.

Dr. Hans Rosling, a Swedish global health professor, was given a humanitarian award at the annual Action Against Hunger gala and was the night's star attraction.

WOMAN: Tonight, you are going to hear from one of the world's most inspired thinkers.

So, ladies and gentlemen, will you join me in giving Hans Rosling a very warm welcome.

(APPLAUSE)

RAY SUAREZ: Over the last five years, this unassuming professor has collected millions of fans around the world with a usually un-glitzy topic: statistics.

DR. HANS ROSLING, Professor of International Health: $1,000, $10,000, $100,000, the difference in income per person in the world is two zeros.

RAY SUAREZ: Dr. Rosling's goal for the evening and the focus of his life's work was to wow his audience and teach it something.

He brings to life global health and development statistics, often dense and inaccessible, using a sophisticated visualization software he and his team created.

DR. HANS ROSLING: Because what do we have on the axis? Here, we have the number of children per woman, one, two, three, four, five, six, seven, eight, large families, small families. And here we have the child mortality, this most tragic marker of the quality of life in a society.

The size of the bubble is the population. This is China. This is India. Look here, low child mortality, small families. High child mortality, large families. What has happened? Here we come. China is very successful there, India coming there, Indonesia. Look here. This is Brazil. This is Mexico coming here. This is Indonesia. This is Bangladesh. Bangladesh is catching up with India. They're overtaking India.

Africa is falling down. And now we see some are delayed here, but almost the entire world is here. It's a completely new world.

RAY SUAREZ: The presentation is one he's been giving audiences at conferences and meetings around the world since he became an Internet phenom in 2006.

That's when a lecture he gave at the annual TED conference, a who's-who gathering of high-tech, design and entertainment leaders, was posted online and quickly went viral.

DR. HANS ROSLING: My students, what they said when they looked upon the world, and I asked them what do you really think about the world, and they said the world is still we and them. And we is Western world and them is Third World.

And, what do you mean with the Western world, I said. Well, that's long life and small family. And Third World is short life and large family. So, this is what I could display here. I put fertility rate here, number of children per woman, one, two, three, four, up to about eight children per woman. Here, I put life expectancy at birth, from 30 years in some countries up to about 70 years.

Are the students right? It's still two types of country? Here we go. Can you see there? It's China. They're moving against better health. They're improving there. Or the green, that's in American countries. They are moving towards smaller families. The yellow ones here are the Arabic countries. And they get larger families.

RAY SUAREZ: Over three million people have now watched this talk online.

DR. HANS ROSLING: And all the rest of the world moves up into the corner, where we have long lives and small family, and we have a completely new world.

(CHEERING AND APPLAUSE)

RAY SUAREZ: Rosling's subsequent online TED talks have also been watched by millions.

I sat down with Hans Rosling during his recent visit to New York to talk about his method and maybe learn a little in the process myself.

Did it occur to you at some point that these lessons you're teaching had to be taught in a better way for people to understand them better?

DR. HANS ROSLING: Yeah, because obviously people do not understand some basic facts.

You see, I find holes, deep black holes of ignorance. And now I try to fill them. That means there are things which are facts, which we know, which still doesn't enter their head -- there are actually less children per woman in Brazil, Thailand and Iran than in Sweden. But it doesn't -- they still have a view of the world that is 25 years old.

RAY SUAREZ: Rosling got his start in global health practicing medicine in rural Mozambique in the 1970s.

While there, he discovered and treated patients with a new paralytic disease he called konzo. He's now chairman of the Gapminder Institute, which is dedicated to building a fact-based world view that everyone understands.

In addition to his popular animated software, which was acquired by Google, Rosling likes to use other visual aids to help him convey information about the world we live in -- Ikea boxes to explain population growth and a washing machine to illustrate how the lives and health of poor women and their families are drastically improved by the device.

DR. HANS ROSLING: So there must be one, two, three, four billion people more will live in between the poverty line and the air line. They have electricity. But the question is, how many have washing machines?

I've done the scrutiny of market data and I have found that indeed the washing machine has penetrated below the air line, and today there's an additional one billion people up there who live above the wash line.

(LAUGHTER)

DR. HANS ROSLING: And they consume for more than $40 per day. So two billion have access to washing machine and the remaining five billion, how do they wash? They wash like this, by hand. It's a hard, time-consuming labor. And they want the washing machine.

RAY SUAREZ: During our conversation, he used LEGO characters to represent all humankind.

DR. HANS ROSLING: Look here. This is one billion people. There's one billion people in Africa. There's one billion people in Europe, one billion people in America.

And, as you know, we are seven. So, all the rest, one, two, three and four, are in Asia. This is the world population. And we know, beyond doubt, that there will be two billion more before we level off around nine to 10. And those two billion, we also know that one will be in Africa and one will be in Asia.

And any CEO of a big company looking, like, they say, wow, that's where the market is.

Believe me, there's nothing boring about statistics.

RAY SUAREZ: In 2010, the BBC aired a documentary about Rosling's work called "The Joy of Stats." Using some high-tech special effects, the production team was able to show his animations in real space.

DR. HANS ROSLING: So, down here is poor and sick. And up here is rich and healthy, Europe brown, Asia red, Middle East green, and the size of the country bubble show the size of the population.

RAY SUAREZ: Can you almost feel when the lights are going on, when people are saying, aha?

DR. HANS ROSLING: Yes, we have.

But it's also -- you have to check after a year if it's still there. And the old concept of the Western world and developing world is very strong. And it's also because it's sort of frightening. People think it's frightening with this Asia and Africa here.

No, these are customers. These are partners. And prosperity in the rest of the world means more peace. The U.S. armed forces doesn't have to make so many interventions in the world if we have less conflict. So it's sort of a new vision about the world we must have.

DR. HANS ROSLING: The bubbles are the countries. Here, you have the fertility rate.

RAY SUAREZ: Rosling says he is going to continue talking about important global health statistics whenever and wherever he can.

Like many successful entertainers and plenty of great teachers, Rosling knows that, once he's got your attention, he can pull out something unexpected.

DR. HANS ROSLING: Bring me my sword.

RAY SUAREZ: In this case, another passion: sword-swallowing.

DR. HANS ROSLING: And I will now prove to you that the seemingly impossible is possible by taking this piece of steel, solid steel, and push it down through my body of blood and flesh, and prove to you that the seemingly impossible is possible.

Can I request a moment of absolute silence?

(DRUMROLL)

(CHEERING AND APPLAUSE)

Ethiopia: A Battle for Land and Water

Tue, 28 Feb 2012 18:31:00 EDT

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A controversial resettlement program in Ethiopia is the latest battleground in the global race to secure prized farmland and water. Correspondent Cassandra Herrman reports as part of the Food for 9 Billion series, a NewsHour partnership with the Center for Investigative Reporting, Homelands Productions and Marketplace.

JUDY WOODRUFF: Now, a struggle over land in Western Ethiopia that pits village farmers against the government and land investors.

Tonight's story is part of a multimedia project that looks at the challenge of feeding the world in a time of social and environmental change. It's a NewsHour partnership with the Center for Investigative Reporting, Homelands Productions and American Public Media's Marketplace.

The project is called Food for 9 Billion.

Tonight's correspondent is Cassandra Herrman.

CASSANDRA HERRMAN: The Anuak people of the Gambella region have lived in scattered settlements like this for centuries, growing maize in wetter months farming closer to the river in the dry season.

But last year, the Ethiopian government launched a program called villagization. Officials told the people here they would be relocated to areas with better access to clean water, health, and education. But this woman says they were forced to move under false pretenses.

WOMAN (through translator): When we left our farm, our crops were ready for harvest, but they told us to leave them in the field, that we would find plenty of corn and other food in the new place we were moving. But they don't give you enough food to fill you up. They give you food in a small container but it can't even feed a family for a day.

CASSANDRA HERRMAN: The plight of the Anuak people is at the heart of a complex battle over landownership and water rights between farmers, the government, and foreign investors. It's a battle that is being fought in many African countries.

The Ethiopian government officially owns title to all the land here, but farmers have the right to use it. The government calls this land abandoned because it's so sparsely populated. But Anuaks say they need it, some for grazing, some to lay fallow, and that it's the best farmland in the country.

MAN (through translator): Moving us to a new village might be good for the government, but not for us. It's not good to move a person from the land they have lived on for generations. Maybe the government thinks we are not worthy enough to live on such beautiful land, and they want to have it.

CASSANDRA HERRMAN: Over the next two years, 1.5 million people in four regions of Ethiopia will be relocated. The government insists that the villagization program is voluntary.

But Human Rights Watch says Anuak are being forced to move so that the government can lease the land to investors. The rights group recently documented cases of violence and arbitrary arrest.

OKOK OJULU, Anuak leader (through translator): Land is political. Land is very emotional. And land is our identity.

CASSANDRA HERRMAN: Anuak leader Okok Ojulu was a voice of resistance against villagization. Fearing for his live, Ojulu fled Ethiopia and now lives in exile in neighboring Kenya.

OKOK OJULU: When I see my village, very small in the face of this big population coming in, I see a big threat. We need to fight for the future of our children.

CASSANDRA HERRMAN: Ojulu says it's not just his people's land that is at stake. Gambella, with several rivers and a sizable dam, is rich in water resources.

Water is the driving force behind many agricultural deals on the African continent. This rice farm is owned by a Saudi sheik and is on land that Anuak consider theirs. According to the company Saudi Star, when completed, this rice farm will be the largest in Africa.

HAILE ASSEGIDE, Saudi Star Agricultural Development: Our objective is to put Ethiopia in the rice map of the world. We would like to export about one million tons of rice. We expect about $1 billion of income for the country.

CASSANDRA HERRMAN: In many places in the world, water is becoming a scarce resource. Saudi Star's rice will go to Gulf nations no longer able to irrigate their own crops.

To attract investors to this area of the Nile River Basin, the Ethiopian government puts few, if any restrictions on water usage in its contracts with foreign companies. Saudi Star will spend $2.5 billion on the rice farm, on clearing forests, on their fleet of new tractors and combines, and on extra experts like Mohammad Manzoor Khan, one of the project's director.

MOHAMMAD MANZOOR KHAN, Saudi Star Agricultural Agency: It's a lot of rice for the world market of local people. This project is generating a lot of income. It can really bring a revolution in poor production, as well as uplifting the social ambitions of the people around.

CASSANDRA HERRMAN: But Ethiopians don't typically eat rice, and many question the move to grow crops for export, when Ethiopia and the Horn of Africa have a long history of periodic hunger caused by war and weather problems.

DESSALEGN RAHMATO, Forum for Social Studies: This country is a country that has suffered food insecurity and famine, still suffers food insecurity, and yet gives out its huge land resources to foreign capital.

CASSANDRA HERRMAN: Dessalegn Rahmato is a food policy expert with the Forum for Social Studies. He says making sure people have access to food should be the government's priority.

DESSALEGN RAHMATO: There is no provision -- in any of the contracts signed by the government and investors, there's no provision for food security, local food security at all. And if there are people who are starving there, it's not their concern.

CASSANDRA HERRMAN: In the capital, Addis Ababa, the government says the way to ensure people can afford food is to provide jobs through attracting investment and foreign currency.

At the Ministry of Agriculture, Director of Investment Essayas Kebede says that as a country of farmers, Ethiopia needs agricultural exports in order to pay for importing necessary items.

ESSAYAS KEBEDE, Agricultural Investment Agency: To have tractors, to have harvesters, to have other equipment and to have fertilizer, we are importing fertilizer. We are importing oil. We are importing everything.

CASSANDRA HERRMAN: But, in Gambella, Anuaks say they are not seeing the benefits of the country's investment strategy. While companies like Saudi Star now have access to much of the region's best land and water, the leader of this village says they've been moved to drier areas where farming is more difficult.

MAN (through translator): If they take all the water from the small river, the river will dry up. Then where would we get water? I heard also that they are planning to take water from the lake a few kilometers from here.

CASSANDRA HERRMAN: The lake he is referring to is the Alwero Dam. Saudi Star is close to finishing an 18-mile canal from the dam to irrigate their rice fields.

MAN (through translator): If I knew they were moving me so they could sell my land, I would have refused to leave, so that they could kill me and bury me in my own land. That would have been better.

CASSANDRA HERRMAN: Many of the relocated communities could face endemic hunger as early as next year, according to Human Rights Watch. Most are still waiting for farms or seed.

More than 12 million Ethiopians are currently in need of food assistance. The future for groups like the Anuak grows increasingly uncertain as the global land rush continues, not just in Ethiopia, but in dozens of countries across the African continent.

JUDY WOODRUFF: You can find the first two reports in this series at the Food for 9 Billion website. There's a link to it on NewsHour.PBS.org.

India Close to Eradicating Polio, But Challenges Still Remain

Mon, 20 Feb 2012 18:36:00 EDT

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Health officials in India are close to wiping out polio, a disease forgotten in most of the world but still endemic in some developing countries. Special correspondent Fred de Sam Lazaro reports on India's challenge to remain vigilant in its campaign to immunize children one mouthful at a time.

JEFFREY BROWN: And next to India, a poor and populous country long plagued by polio, but now health officials have come close to wiping out the disease.

Special correspondent Fred de Sam Lazaro explains how that was accomplished.

FRED DE SAM LAZARO: In India, the battle against polio is being fought one mouthful at a time. Vaccinators have fanned out with coolers containing vials of the oral vaccine on a scale befitting a nation of 1.2 billion, says Lieven Desomer, a campaign strategist for the U.N.

LIEVEN DESOMER, UNICEF: One national round, we reach almost 75 million children, 150,000 supervisors, 1.2 million vaccinated.

FRED DE SAM LAZARO: They look for families especially at bus and train stations in the populous northern states, where polio is most endemic.

They look for young children, making sure first to check their pinkie fingers, where an indelible ink is placed once a child is immunized. Thousands of times, with little fuss, each vaccinator has administered the two-drop dose of vaccine. As a result, India, one of four countries where polio is still endemic, may soon become free of it.

It's easier to see how India can be a breeding ground for polio. Hundreds of millions of people lack proper sanitation, conditions that allow the virus to spread, usually attacking children, causing paralysis in some victims and in a few cases death.

In addition, it's difficult for public health workers to track the movements of India's huge nomadic and migrant populations. On any given day, 19 million people are on a train somewhere in India. That's why experts say the huge drop in polio cases -- they were up to 150,000 a year in the '80s -- is remarkable.

As recently as 2009, there were 741 cases of polio in India, more than any other nation. By last year, 2011, the number had dwindled to one solitary case, what campaigners hope will be the last one they will ever find in India.

LIEVEN DESOMER: I have to pinch myself once in a while to really realize that we actually -- we're almost there. And, for me, it's amazing being here, because it's part of history. We are making history here.

FRED DE SAM LAZARO: Desomer is with UNICEF, with, along the World Health Organizations, the U.S. Centers for Disease Control and Rotary International, partnered with the Indian government in the multi-year $2 billion-plus campaign.

He says a few years ago, many impoverished communities resisted the vaccine.

LIEVEN DESOMER: These were communities which have not benefited from all the progress in India. And they have no roads, no clean sanitation. And they would usually campaign to say, you can reach us with a drop of vaccine. Why can't you reach us with education and health and good water and sanitation? So, that is one thing.

FRED DE SAM LAZARO: So they were suspicious?

LIEVEN DESOMER: They were quite suspicious.

FRED DE SAM LAZARO: Suspicion that the vaccine wasn't what was claimed was particularly high among India's Muslim minority.

Mufti Mukarram Ahmed, imam of the Fatehpuri Mosque in substantially Muslim Old Delhi, says memories are still vivid of coercive attempts by the government in the '70s to sterilize people here.

MUFTI MUKARRAM AHMED, Imam (through translator): People thought that in the polio vaccine, they placed some medicine to sterilize people. They think that just like in the time of Sanjay Gandhi, when sterilization operations were going on, they think now, instead of doing operations, they can just give this medicine to the Muslim community and our men and women will not be able to have children.

FRED DE SAM LAZARO: He was among many religious leaders who were approached by doctors and the U.N. agencies, reassured of their intentions, and brought on board to endorse the polio campaign.

Also coaxed in were Bollywood megastars like Amitabh Bachchan. In this TV spot, he angrily tell parents to put aside excuses like the fear of caste or religious discrimination and immunize their children.

AMITABH BACHCHAN, actor (through translator): Have you lost your mind?

FRED DE SAM LAZARO: His co-star in the ad, Shahrukh Khan, is Muslim.

SHAHRUKH KHAN, actor (through translator): His anger is justified. What's the connection between caste or religion and polio? Any child can get this disease. That's why I too have vaccinated my kids against polio. Now you please go and do the same.

FRED DE SAM LAZARO: Perhaps the most significant buy-in that helped the polio campaign came from the government at all levels, according to this Dr. Hamid Jafari with the World Health Organization.

DR. HAMID JAFARI, World Health Organization: The government of India has funded the largest chunk of this program, you know, up to $250 million each year, which is unprecedented compared to other countries.

FRED DE SAM LAZARO: The government declared that any polio virus citing must be treated as a public health emergency. Jafari says that allowed for vigorous surveillance and response. Old reports of paralysis in children were investigated.

DR. HAMID JAFARI: In 2011, nearly 60,000 cases of acute flaccid paralysis were reported and investigated. And only one of those cases, the one that had onset on Jan 13., we were able to isolate polio viruses -- virus. The other cases were due to non-polio causes of acute flaccid paralysis. So that tells you how sensitive the civilian system is.

And there are international standards. And those standards are now being exceeded.

FRED DE SAM LAZARO: He says the big lesson from India for Nigeria, Afghanistan and Pakistan, three other countries where the virus is endemic, is that polio here became a huge, widely publicized national cause, much more than a public health campaign.

DR. HAMID JAFARI: You're talking about community leaders, religious leaders, academic leaders, opinion leaders, so just getting -- really turning it into sort of a national movement, so that everybody feels that they are part of this movement.

It's not only just the health department that has to deliver on this. And I think that's the kind of tipping point for Nigeria and Pakistan. I mean, these two countries have done a lot of good work and have made a lot of progress. It's what it is going to take to bring them to the tipping point where India is now.

FRED DE SAM LAZARO: For India, the challenge is to remain vigilant and polio free for two more years to officially fall off the list of endemic countries.

Government officials say they next want to use the polio system and teams to tackle other relatively neglected diseases, like measles. Longer-term, the challenge is to build basic sanitation and education systems, things that can prevent disease in the first place.

Fred's reporting is a partnership with the Under-Told Stories Project at Saint Mary's University in Minnesota.

On our website, Hari Sreenivasan talks with two doctors from the Centers for Disease Control about curable and preventable illnesses.

A Look at the World's 'Forgotten' Diseases

Mon, 20 Feb 2012 18:34:00 EDT

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With news that India is close to eradicating polio, eyes turn to other endemic diseases, such as measles and river blindness, that countries are battling.

"They are often ignored," Dr. Mark Eberhardt of the Centers for Disease Control and Prevention told the NewsHour's Hari Sreenivasan. "There was often thought to be very little that could be done for them which has led to neglect from the scientific community and even the local population."

Eberhardt, who specializes in Neglected Tropical Diseases, and Dr. Stephen Cochi, a measles and polio specialist also from the CDC, described the diseases and why they still need attention.

Chronic Malnutrition a 'Hidden Crisis'

Thu, 16 Feb 2012 17:18:00 EDT

A woman lies next to her child as he recuperates from malnutrition at a Doctors Without Borders clinic in southern Ethiopia in 2008. Photo by Siegfried Modola/AFP/Getty Images.

About 2 million children who are malnourished die each year worldwide, according to a United Nations estimate. Yet aid organizations say it's tough to attract attention to the issue of chronic malnutrition in a preventative way -- before it becomes severe and life-threatening.

Save the Children issued a report this week hoping to sound the alarm and highlight behavioral changes and other known practices that can help.

"Oftentimes, we all tend to fixate a bit on the acute side of malnutrition and what we typically have in our mind's eye about a wasted emaciated child," said Karin Lapping, senior director for nutrition at Save the Children. "But actually what is more prevalent and contributes more to child deaths at the end is chronic malnutrition."

Globally, a quarter of all children are malnourished, but in some developing countries it can be as high as a third or even half, said Lapping. And being malnourished contributes to the life-threatening nature of other illnesses, such as childhood diarrhea and malaria, she said.

Cat Cora, a Greek-American professional chef and past winner in the "Iron Chef" television series, recently visited Ethiopia -- where more than 40 percent of children are chronically malnourished -- to learn about the problem and try to raise awareness in the United States.

"In the United States it's very hard to understand the word 'food insecurity,' because we have such abundance here," she said. But "I don't care whether you live in Los Angeles or Ethiopia, mothers have the same concerns for their children" -- they want them to grow and thrive.

Solutions exist right now to solve the problem, said Lapping. Save the Children's report points to several solutions also outlined in a 2008 Lancet medical journal series on malnutrition:

breastfeeding until the child is 6 months old;

providing Vitamin A and zinc supplements to children;

fortifying staple foods at the production site, such as adding iron to flour in mills; and

encouraging healthy behaviors including hand-washing.

Products such as nutritionally enhanced peanut paste work for curative purposes, and are undergoing studies to see how they would work for prevention, said Lapping.

Several years ago, the French company Nutriset introduced Plumpy'nut, a product aimed at bringing severely malnourished children back to good health within weeks.

Many relief organizations have embraced the paste, in part because it's easy to produce, easy to store (no refrigeration required) and -- at a cost of $60 for a two-month regimen -- relatively inexpensive to purchase.

Nutriset's general manager, Isabelle Lescanne, stopped by the NewsHour recently to talk with Ray Suarez about Plumpy'nut and other products in the works to help prevent malnutrition, along with the controversy over Plumpy'nut's patent that restricts wide-scale production of the power-packed paste in North America and parts of Europe:

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But even without products, behavioral changes and education in basic dietary needs can help combat malnutrition, Lapping continued. For example, teaching mothers to breastfeed their children exclusively until they are 6 months old will prevent the risk of introducing contaminated water into their young developing bodies and will help develop their own immune response.

Rather than just focusing on the mothers, aid organizations urge the inclusion of the whole community, including husbands, fathers, mothers-in-law and religious leaders -- anyone who can "really influence the ability of a mother to practice these good behaviors," said Lapping.

The issue of chronic malnutrition got a boost at the G-8 Summit in L'Aquila, Italy, where member nations issued a Joint Statement on Global Food Security.

Of the $22 billion pledged for food security at the summit, 3 percent was earmarked for nutrition and of that 1 percent was delivered, said Lapping. Save the Children would like to see the L'Aquila pledge extended and the amount for malnutrition increased to 15 percent. The World Bank estimated that $10 billion per year is needed to address chronic malnutrition, she added.

"There is in fact this hidden crisis and there's a problem that if we don't act now, within 15 years we'll see another half-billion children affected by chronic malnutrition that can be prevented," she said.

Watch the NewsHour's latest report in the series "Food for 9 Billion," which explores the issue of food security and how some poor fishing families in the Philippines are embracing birth control to ease pressure on over-fished reefs:

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Hans Rosling Brings Life, Humor, Sword-Swallowing to Global Health Statistics

Mon, 30 Jan 2012 18:36:00 EDT