Monday, August 25, 2014

when good causes receive an ice bath

If your circle of friends is anything like mine, your news feed is probably being overrun with pictures and videos of people getting buckets of ice water dumped on their heads.

The Ice Bucket Challenge was created in support of the ALS Association that researches amyotrophic lateral sclerosis, or Lou Gehrig’s disease. The idea for the frozen fundraiser went viral soon after that first bucket of ice water was dumped, and in one short month, the ALS Association has raised more 50 million dollars.

More than 50 million.

I still can’t really wrap my mind around that. In just a month - that is quite the chunk of change and I can’t resist doing the math and figuring out what that kind of money would fund in the area where we work. I’m fairly confident that we could eradicate child malnutrition, provide potable drinking water for all, send every highschool graduate to college, ensure a consistent medicine supply at every hospital, AND we could do this not only in our area but throughout the province, AND we could do it all NOW. Because, after all, 50 million dollars is Choshen Farm’s annual operating budget for the next 500 years.


As the Marketing and Communications Director (I gave myself that title, do you like it?) for our small, but significant organization, I can’t help but pay attention to what I’m seeing all over the interwebs. As so many people around the country, including so many people that I know personally, have gotten on board with a fundraising initiative as big as the ice bucket challenge, you better believe I’m taking notes.

There are plenty who have lost family or friends to Lou Gehrig’s disease and their participation in the ice bucket challenge has taken on a personal and significant meaning. But the viral nature of the campaign tempts me to believe that love and concern are not the grand motivators amongst the majority. I think the ALS campaign has been so successful because of its ability to make fundraising cool.

All the cool kids, including Michael Jordan and Ben Affleck, are doing it, and the message traveling fast is that you can too! For only $10, you can secure your claim to fame, being the next in line to join the club. The desire to be “in with the in” clearly does not dissipate after sixth grade and “everybody’s doing it” is as motivational as ever. A dare is basically irresistible, especially when the clock starts ticking and you’re told you have exactly 24 hours. Group-think is real and the marketers know it.

There has been some fantastic press surrounding the ice bucket challenge and hearty discussion about medical research and the shortage in public funding. But there has also been some push-back, critics questioning the wisdom of the campaign, with others highlighting the financial stewardship history of ALS or the relatively small number of Lou Gehrig’s disease sufferers compared other diseases. The author of a recent Slate article called participation in this campaign a “particularly ineffective way of spending your philanthropic dollar.”

But I don’t think that pros and cons and financial oversight and organizational vetting has been at the forefront of most people’s decision to jump on the bandwagon. The fad has been set in motion, and millions have been won over… The ice bucket challenge is a good gauge of the current fundraising climate in America.

And it worries me.

We are preparing to go back to the states for three months, carrying with us a just cause and compelling information and fire in our bones. Yet still, in light of all the ice bucket fervor, I’m feeling a little fatalistic about it. We are going to be traveling around trying to raise about $50,000 for special projects in the Fimpulu community – a mere 0.1% of what AIS has raised in the last month. The need Zambia is great and the potential impact is even greater and I know this! … and yet… I still rushed frantic into our office (kitchen) yesterday and blurted out to Jeremy, “We’ve got nothing!!!” To which he replied, “Excuse me?” And I explained, “We have no ice water!”

not an ice bucket challenge, just a bucket bath, because that's how we roll

 Melodramatic though I am, I think I am carrying around in my gut a legitimate concern about the recent trend in American generosity. If the ice bucket challenge has taught me one thing, it is that the coolest campaign, and not the worthiest cause, that ultimately gets the dough.

ALS is certainly not the only successful organization to pull this off. Traditional support letters and verbal communication are fast approaching archaic in this new fundraising atmosphere characterized by concerts and 5k’s and jewelry-made-by-widows-theme-parties.

Calling these fundraising strategies what they are – gimmicks – sounds both crass and confrontational, but it is true nonetheless. Big organizations have a lot of good things to accomplish both at home and abroad and many, many dollars are needed to make it happen. But experience has taught us all that the organizations with the greatest cause had better have one heck of a marketing team specializing in stage production.

“Give the donors what they want” is rule number one in the fundraising world; and about five seconds on facebook clearly identifies that what the donors want is excitement and fanfare and something share-worthy. This is the millennial generation for you, and to a certain degree, the X and Y generations as well – deeply experiential and motivated primarily by emotion. Hardly won by mere propositional truth of here is the need and here is why you should give – the 20 and 30 somethings of today simultaneously engage their wallets and narcissistic world-view, sitting like Howard Stern as a judge on “America’s Got Cause,” buzzing through organizations not by their long-term, sustainable output but by the dazzle of their 30 second fundraising fanfare.

And here is where we, the little people of the fundraising world, feel the rub. Tons of worthy, urgent, compelling causes plod along underfunded because their marketing strategy does not optimally include the cool/fun/entertainment factor. Maybe we are too busy doing the hands-in-the-dirt kind of work to create the bejeweled marketing scheme. Maybe our consciences require that our limited funds meet the immediate needs around us instead of blowing them on light shows and set design.

my focus is here. 

 And maybe I need to crawl down from my high horse and just give people what they want. Maybe so. 

But our little bush-dwelling marketing team of two does not play this game well. We have spent too much time reading missionary biographies and histories of the church and we know that once upon a time, it was not like this. There was an era, before facebook, when donor bases consisted of people whose support stemmed more from conviction than entertainment and who asked one question only to determine a cause’s worth: Is God in it? And if the answer was yes, their hearts and wallets opened. And their eyes closed. Because Is God in it? is much less a question of intrigue and much more perception through prayer.

My fear in going back to the states and working to raise this money is the fear that America has lost this discipline of old, the discipline of asking the right question (Is God in it?) to determine the right answer (Yes, and I give; or No, and I don’t give.). I fear that our eyes have grown so accustomed to the bright lights of the stage and waiting for the show to begin, that our senses have dulled towards what is truly brilliant in character and not just facade. I fear that in conditioning our eyes to the light of our iphones we have become disused to the darkness of eyes in prayer, waiting for the still small voice.

I can’t dictate for everyone who to give to or how to decide and I’m not even swinging this piece to say that you should give to Choshen Farm and an not ALS - not at all. All I know is that we would rather raise $50,000 prayer-filled dollars than $50,000 fast and flashy ones knowing that the former is the kind of campaign that will echo into eternity. And I still believe that there are generous folks out there who want their dollars to echo too.

What do you think? What kind of marketing ethos do you want your charitable organizations to have? What kind of donor do you want to be?

Monday, August 18, 2014

when "better than nothing" is euphemism for "crap" and 21 things to do about it

There’s a phenomenon that often crops up when privilege awkwardly mingles with poverty. I like to call it the “better than nothing” effect.

 I’ve written about digging through salaula to look for used clothes. What I failed to mention in that post is that many of the clothes in those piles are disgusting. Onesies with poop stains all over them, trousers with large rips down the seams, shirts that are pitted out all icky and brown. The presence of such “clothes” (if you can even call them that) makes me wonder, why did the previous owner not just throw this trash away?  And the answer rings in my head like an obnoxious pre-recorded message: well, it’s better than nothing. (I think I’d rather continue to let Bronwyn run naked.)

AWANA Chums: bless it.
Service projects in poor areas are susceptible to this logic as well. We’ve seen it many times over – buildings thrown up in haste because the team is leaving in a week, paint spattered on walls, teaching materials thrown together with church leftovers that no one wanted. I wonder, is this how the church cares for its own building/members/seekers? And the pre-recorded message plays again: well, it’s better than nothing.

All poor people are always this joyful and content, right?
Lest I be unfair, I must also point out that this dynamic does not exist merely between the American/White/Privileged and the African Poor. This is an “in-house” dynamic as well. Over and over, I’ve attended meetings with NGO workers from Lusaka – Zambian born, yes, but city raised, university educated: privileged and elite. When urban meets rural, the clash of power is always evident. Arriving in vehicles and talking on iphones, the Lusaka folk provide food that they themselves refuse to eat and give bicycles that they themselves would never ride and set up sub-par systems at clinics and schools that they themselves would never take their children too. How is any of this acceptable? Cue tape: well, it’s better than nothing.

I see it. I hear it. And sometimes I do it too. Sometimes my empty water bottle really is the kid next door's new prized possession. Sometimes Bronwyn's hand-me downs are a life-saver for the family whose house just burnt down. Sometimes that scrap paper is destined not to become kindling but rather the next generation of fighter airplanes.

But often times, crap is crap no matter the context context. The rubbish hand-outs and poor craftsmanship and programing that starts three hours late because they are poor and have nothing else to do so they can wait for us... As fancy-dan Zambian government vehicles drive down the road and throw their chicken bones out for the window for the kids waving happily, I cringe, and the lack of refinement unsettles me. The subtle message from the powerful to the weak, from the rich to the poor, is, you are not worth more than this. You are not worth more than polluted water and rags for clothes and long-enough-to-die-in lines and crowded classrooms and janitors diagnosing your disease.

How did we get here? Not as a race or an ethnicity but as human beings? How did the subversive better than nothing creep into the story of mankind? I suppose it happened that somewhere along the way we stopped seeing every woman as our sister, every old man as our father, every toddler as our child. Their life and their story became so very far from ours and caring without sacrificing became the norm because it is so easy -  and seemingly so acceptable. The shift towards "us versus them" and “better than nothing” was innocuous when the scale was pitifully small, and "giving to Africa" was not a thing. But now, in the age of BIG AID and development and mercy ministries and poverty ministries and social media calling attention to the needs and plights of the poor next door - people are giving and sending and going and engaging at a dizzying pace… and its time to realign our thinking.

I pray for this every time I sit on an airplane with teams and teams of Americans flying over on some kind of missions trip to Zambia. I pray for this every time I walk into a Government office to ask for any kind of anything. I pray for the dismantling of “better than nothing” and the raising of a standard of excellence based on the premise that this person breathes. To rename “that poor black child” (and please stop saying that), to “my dear friend.” Poor is not a name or an identity; its an economic descriptor - nothing else - and to recalibrate the quality of our kindness based on that word alone redefines a soul’s worth in terms of dollars and no doubt makes the Creator grieve.

Because I think many of these actions are subconscious – more a reflection of cultural shift and mass media than our heart of hearts - might I suggest a few things?

1. Never donate clothes or food that you would never wear or eat yourself.

2. Do not send busted or broken toys or electronics.

3. Give gifts with the same intentionality and delicacy as you would your best friend.

4. Construct, paint, build as you would your own home.

5. Learn names. As many as possible. And stories to go with.

6. Provide what is requested, not just what is convenient or left over.

7. Submit to local authority.

8. Empower without paternalism.

9. Don't assume you understand the real needs. 

10. Improve broader systems and structures as you are able.

11. Slow the giving flow enough to investigate the micro-economic impact.

12. Engage local labor as much as possible.

13. When serving amongst the poor, become poor. Let your heart be broken – for in doing so you will know the heart of God.

14. Give freely.

15. Give prayerfully.

16. Give without expectation or condition.

17. Give sustainably.

18. Give humbly.

19. Keep learning.

20. Keep trying.

21. Live by Psalm 82:3: Defend the rights of the poor and the orphans; be fair to the needy and the helpless.  

Bless and be blessed. 
. . .

what else can you add?

Tuesday, August 12, 2014

where there is no burn unit

I already don’t like this post, and I haven’t even started writing it. It goes against my blogger ethics to share personal stories like this with a broad and unknown internet audience, but I’d like to say that I have obtained permission from each person featured in this post. My friends pictured here want your help. I want your help. We both want the first world to know the rural third world reality.

Please read, and feel, and respond. I’m praying for a flood of advice from real live Peds and PTs, ER nurses and good Samaritans.


I started to post more info about this on facebook and realized that I do not have the space (or patience of thumb typing) to make this happen.

Let me start with the background info: a story of three burn victims.

Michael’s foot and leg were burnt by boiling water that tipped from the fire. His mother took him from the clinic and they kept him over night for observation. They gave him acetaminophen and washed the wound with bleach water. Before sending him home the next day, they drugged him up with sleeping pills so that he wouldn’t be too active and get the wound dirty. After a time, the wound got infected. He had been discharged from the clinic a few days prior with no instructions, and so his mother turned to traditional medicine. She put toothpaste and ashes on the wound and left it. The infection got worse and Michael’s pain increased. I asked if I could wash the wound each day, which the family was glad for and it eventually cleaned out and healed.  The skin around the ankle grew back tight and he has thick scaring at the site, but is otherwise fine.

Kalunga tripped into a pot of boiling water and burnt his leg from hip to toe. His mother also took him to the clinic where they also gave him acetaminophen and washed the wound with bleach water.  After being discharged, his mother took him to the clinic for regular cleansings with bleach water during which Kalunga screamed so badly at the pain, breaking his parents’ hearts. They could not stand watching the clinical cleaning procedure. They kept him at home and used ash to pack the wound and after a time it got severely infected. I offered to help him clean the wound and kept Neosporin on the area, re-bandaging his leg twice a day for two weeks. His skin did heal, though the area around the knee has limited range of motion and he limps a bit when running.

Bana Miri lost consciousness and fell into an open fire. No one knows how long her arms were laying in the fire, but her flesh was incinerated to the point that we could see bone. She was referred directly to the hospital where they gave her acetaminophen and washed her wounds with bleach water. After a few days, she was discharged. The family cared for the wounds with toothpaste and ashes. After a few weeks, the family called me because her wounds were so rancid that anyone who walked into the house commented on the rotting fish smell. I took her straight back to the hospital where they continued to soak her hands and arms in bleach water. After a few more weeks of negative progress, they transferred her to a hospital in Kitwe where the doctors started talking amputation. The family pleaded that she be able keep her hands, so after getting the infection under control, the hospital sent her home. Bana Miri no longer has any functional use of her hands.

Do you hear the commonality in each story? Tylenol, bleach, end of clinical care, ashes and toothpaste, infection, and permanent damage.

When Bronwyn was burnt in similar manner a few weeks ago, many people urged me to take her to the hospital. I hope you can appreciate now why I opted not to. If Tylenol and bleach were the solution, I could have done that myself. Thankfully the water that fell on her was not fully boiling and her skin never burst and nothing got infected. We are thanking God for this mercy.

But the prompting of this post comes from a more recent story.  Please keep reading.

Four days ago, Patience’s sister dropped a pot of boiling oil and the oil splashed across Patience’s legs. Her mother was not home, but the neighbor lady immediately covered the burned area with toothpaste and stared walking with her to the clinic. At the clinic, the nurses scraped the toothpaste off and kept the wound clean with bleach water. One tube of Silver Sulfadiazine was in the cabinet (and no one knows where it came from, so I’m calling that a miracle) which they put on the child’s knees until the tube ran out and they sent her home. (Note that Silver Sulfadiazine did not exist in Mansa at the time of the first three burn cases, which is why there is no mention if it in their stories.) Now at home, her mother is too afraid to hurt her child, and she has asked me to be the home aid nurse, which I am certainly not.

Naturally, I am terrified. I am terrified that her knees will not heal properly, that she will not be able to bend them. I am terrified that she will be in unnecessary pain. I am terrified that I do not know what I am doing. As I asked for help on facebook, many responded that I should take her to the hospital. I hope that the above stories shed some light on that option. The one difference in Patience’s story is that I now know about and have access to Silvadene. A newer pharmacy in Mansa now carries it and, after Bronwyn’s burn, I stockpiled. (It’s a shame that I am willing to buy this medicine, but the Ministry of Health is not. But that is a post for another day.)

Please know that all of these people are dear to us. Michael is named after my husband. Kalunga has the most contagious laugh and has been on my top-five-people-on-the-planet list for a long time. Bana Miri is the wife of one our former staff members (he stopped working with us to care for his wife full time) and she is the BEST. Patience is one of Bronwyn’s friends – they have played together since birth. These people are important to us – they are not just names or pictures or case studies.

But I am not a medical professional and other questions remain. Questions about the sloughing that the clinic seems obsessed with – scraping back the clean-but-dead tissue until her knees bleed. Questions about their wrapping technique. Questions about the Silvadene application. I don’t want this little girl to end up like the others. I cannot distance myself emotionally from this situation either. Her cries are fierce and I’ve wept for her pain. I look at her laying miserable and imagine Bronwyn and I can’t not commit to her healing.

There are complicated sub-stories woven tightly into each of these burn scenes. Stories of poverty and the daily hazard of cooking on fires. Stories of inadequate health care and sub-par patient education. Stories of apathy in resource sparse locations. Stories of traditional medicine and witch doctors and mothers that would do anything – try anything – to make their babies feel a little better.

And these are stories that also need to be told and hopefully will be told at some point. But right now the clock is ticking and I have one hour, thirty three minutes until I am due to arrive at Patience’s house to “help” her mother and my cheeks are tear stained and my hands are trembling.

This is me reaching out. Who will skype facetime with me from inside Patience’s house? Who will look at pictures and advise wisely? I have access to google and I am using it. I’m looking for specialized advice for individualized care, not because I think webMD is wrong but because I can’t stand being involved in another burn victim story without reassurance of a qualified, live person telling me that this is the best anyone could do.


And thank you.