If you have ever flown with US Airways, then you may already know Steve Hoesel.
When the pilot isn't telling you to put on your seat belt and prepare for what you hope to be a safe landing, he is busy helping orphans in Africa and, running a non-profit charity.
The Gilbert resident, who lived in Arizona since age 8, grew up in a family of pilots with flying in his blood.
"My dad was a pilot, his dad was a pilot," Hoesel said. "When I flew by myself for the first time, that's when it hit me that this is what I want to do."
Last year he realized his passion for helping others when he went on a trip with his church, the Grove Bible Church, to a village in Malawi in southeastern Africa and saw the desperate conditions the villagers were living in.
"We asked the chief, 'What is your Number 1 priority?' and he said, 'We need water . . . we haven't had fresh water in over four years,' " Hoesel said.
"So we (the church group) took it upon ourselves and raised the money to put in a new water well so they could have fresh water." said Hoesel.
This year Hoesel returned to Africa to find the well intact and pumping fresh water.
"It was so incredible. To see these kids and these moms and know they had fresh water was amazing." Hoesel said.
Hoesel also distributed mosquito nets to help thwart the spread of malaria.
The group bought more than 1,300 nets and distributed them to six villages and orphanages, which Hoesel estimated helped anywhere from 1,800 to 2,000 people.
The greatest joy that he had while in Africa, however, came from working with orphans and widows.
"A highlight for me this year was going into a widow's home, where she might be caring for four to five children, and has really nothing to live on . . . and I went into the market and bought some things for her like a mat for her to sleep on, beans, rice, veggies, dried fish," Hoesel said. "When I presented these things she just looked like she was going to burst. She was so grateful and it was so humbling.."
Hoesel and his wife, Susie, have 8-year-old twin sons, Andrew and Charlie.
When asked, Hoesel says his greatest accomplishment is being a dad.
Hoesel's charity work isn't limited to Africa. He also co-runs a non-profit foundation set up to instruct future pilots.
"What I do is take kids up (in the co-owned plane) free of charge, and give them an introduction to flight," Hoesel said.
The foundation was recently set up in memory of fallen Tempe police officer Jeff Allman, and donations such as money or gas are accepted.
To date, Hoesel says he has flown a couple of dozen kids and the joy on children's faces is all he needs to remember why he chose to do this.
"Seeing the excitement and these kids, it reminds me of why I got into flying in the first place." Hoesel said.
Friday, 18 July 2008
MALAWI: Derivatives used to hedge against bad weather
LILONGWE, 18 July 2008 (IRIN) - Malawi, riding high on recent cereal surpluses, is hedging its bets against inclement weather disrupting its good fortune by using a financial derivative to offset agricultural risk.
Unlike insurance, weather derivatives are financial contracts based on an underlying weather index; in the case of Malawi the index will use a model that estimates maize production based on rainfall data.
The thresholds underlying the rainfall index are based on a national maize yield assessment model used by the Malawi Meteorological Office since 1992 for forecasting maize production in the country.
David Rohrbach, a senior economist at World Bank's Malawi office, told IRIN the goal was to reduce vulnerability to weather shocks in the context of strengthening food security.
"First, it is important to note that this is not a formal insurance policy, as might be transacted through an insurance company, with a payout when a problem is judged by the company to have occurred; this is a contract on the international weather derivatives market," he said, because the contract was based on rainfall levels.
Rohrbach said the index captured the impact of the timing, amount and distribution of rainfall during the growing season. This allowed the model to determine the impact of early-, mid- or late-season drought on the maize harvest. Daily rainfall data is collected from about 20 rainfall stations used to supply data for the model.
"In simple terms, if the rainfall level is above a given threshold there is no payout. If rainfall drops below the threshold, a payout occurs. The payout grows as the severity of drought increases up to a maximum level. In effect, there is no need to confirm that the country or any particular farmer actually suffered a loss," Rohrbach said.
In June the World Bank agreed to create a new weather derivatives product, allowing Malawi to use the financial markets to offset risks from drought. The weather derivative market began in the US in 1997 and has rapidly grown into a multibillion-dollar industry used by investors ranging from agricultural industries to sporting events organisers.
Malawi introduced a fertiliser subsidy programme in the aftermath of the 2005 drought, which left nearly five million people in need of food aid, and has since become increasingly food secure.
The government estimated the 2007 maize crop at 73 percent higher than the average for the past five years. Around two million tonnes of maize are required annually to feed the population of about 12 million, but the country has harvested a surplus of about 1.5 million tonnes.
Pilot project
According to the World Bank, Malawi's weather derivatives transaction will test the market with a small contract that is expected to pay out a maximum of about US$3 million if severe weather conditions prevail. The premium for the initiative will be paid by the United Kingdom's Department for International Development (DFID).
A similar transaction was completed in Ethiopia in 2006 under the auspices of the World Food Programme. "In that case no payout was made because Ethiopia experienced favourable rainfall," Rohrbach said.
The World Bank Treasury will act as an intermediary on behalf of Malawi to facilitate the country's access to the international weather derivatives market, thereby reducing transaction costs. Malawi will pay the World Bank Treasury for the costs of the transaction and receive any payout generated.
As the international weather derivatives market becomes accustomed to these transactions, the World Bank expects the Malawian government - and other governments - to begin pursuing such transactions independently.
"In sum, if there is significant drought in the country, the government will get a payout whose level is determined by the size of the premium paid and the severity of the drought. This payout may be used to help purchase grain to resolve supply shortfalls or to distribute grain from national strategic grain stocks," Rohrbach said.
"One caveat: payouts are most likely if drought is severe. If drought is restricted to a small part of the country, or is not severe, there may only be a partial payout or none at all."
Unlike insurance, weather derivatives are financial contracts based on an underlying weather index; in the case of Malawi the index will use a model that estimates maize production based on rainfall data.
The thresholds underlying the rainfall index are based on a national maize yield assessment model used by the Malawi Meteorological Office since 1992 for forecasting maize production in the country.
David Rohrbach, a senior economist at World Bank's Malawi office, told IRIN the goal was to reduce vulnerability to weather shocks in the context of strengthening food security.
"First, it is important to note that this is not a formal insurance policy, as might be transacted through an insurance company, with a payout when a problem is judged by the company to have occurred; this is a contract on the international weather derivatives market," he said, because the contract was based on rainfall levels.
Rohrbach said the index captured the impact of the timing, amount and distribution of rainfall during the growing season. This allowed the model to determine the impact of early-, mid- or late-season drought on the maize harvest. Daily rainfall data is collected from about 20 rainfall stations used to supply data for the model.
"In simple terms, if the rainfall level is above a given threshold there is no payout. If rainfall drops below the threshold, a payout occurs. The payout grows as the severity of drought increases up to a maximum level. In effect, there is no need to confirm that the country or any particular farmer actually suffered a loss," Rohrbach said.
In June the World Bank agreed to create a new weather derivatives product, allowing Malawi to use the financial markets to offset risks from drought. The weather derivative market began in the US in 1997 and has rapidly grown into a multibillion-dollar industry used by investors ranging from agricultural industries to sporting events organisers.
Malawi introduced a fertiliser subsidy programme in the aftermath of the 2005 drought, which left nearly five million people in need of food aid, and has since become increasingly food secure.
The government estimated the 2007 maize crop at 73 percent higher than the average for the past five years. Around two million tonnes of maize are required annually to feed the population of about 12 million, but the country has harvested a surplus of about 1.5 million tonnes.
Pilot project
According to the World Bank, Malawi's weather derivatives transaction will test the market with a small contract that is expected to pay out a maximum of about US$3 million if severe weather conditions prevail. The premium for the initiative will be paid by the United Kingdom's Department for International Development (DFID).
A similar transaction was completed in Ethiopia in 2006 under the auspices of the World Food Programme. "In that case no payout was made because Ethiopia experienced favourable rainfall," Rohrbach said.
The World Bank Treasury will act as an intermediary on behalf of Malawi to facilitate the country's access to the international weather derivatives market, thereby reducing transaction costs. Malawi will pay the World Bank Treasury for the costs of the transaction and receive any payout generated.
As the international weather derivatives market becomes accustomed to these transactions, the World Bank expects the Malawian government - and other governments - to begin pursuing such transactions independently.
"In sum, if there is significant drought in the country, the government will get a payout whose level is determined by the size of the premium paid and the severity of the drought. This payout may be used to help purchase grain to resolve supply shortfalls or to distribute grain from national strategic grain stocks," Rohrbach said.
"One caveat: payouts are most likely if drought is severe. If drought is restricted to a small part of the country, or is not severe, there may only be a partial payout or none at all."
Malawi Operator Plans $28 Million Rural Expansion
Malawi based mobile operator, (Telekom Networks Malawi) TNM has announced that it has set aside $28-million to upgrade its network and expand coverage in rural areas. The move follows an announcement by rival operator, Celtel Malawi last month to spend US$90 million on expanding its network over the next year.
last October, Malawi Information and Civic Education Minister Patricia Kaliati warned that the government would revoke the telecom operator licences if they didn't expand their coverage to rural areas.
Celtel is the larger of the two networks operating in Malawi, and according to figures from the Mobile World database, ended last year with 654,000 subscribers which represents a market share of 60%. The country itself however had a population penetration level of just over 8%.
The Malawi telecoms regulator, Macra also recently started advertising for a fourth mobile phone operator, even though the license for the 3rd operator has still not been allocated. Malawi’s Minister of Information and Civic Education, Patricia Kaliati said that the country needs more competition in the phone market to drive down prices and improve rural coverage. She also said that the outstanding 3rd license would be granted once a new board is elected to manage the regulator.
last October, Malawi Information and Civic Education Minister Patricia Kaliati warned that the government would revoke the telecom operator licences if they didn't expand their coverage to rural areas.
Celtel is the larger of the two networks operating in Malawi, and according to figures from the Mobile World database, ended last year with 654,000 subscribers which represents a market share of 60%. The country itself however had a population penetration level of just over 8%.
The Malawi telecoms regulator, Macra also recently started advertising for a fourth mobile phone operator, even though the license for the 3rd operator has still not been allocated. Malawi’s Minister of Information and Civic Education, Patricia Kaliati said that the country needs more competition in the phone market to drive down prices and improve rural coverage. She also said that the outstanding 3rd license would be granted once a new board is elected to manage the regulator.
CPC delegation leaves for visits to three African nations
BEIJING, July 18 (Xinhua) -- A friendship delegation of the Communist Party of China (CPC) left Beijing Friday evening for visits to Malawi, Zambia and Tunisia.
The delegation, led by Vice Minister of the International Department of the CPC Central Committee Li Jinjun, will pay friendly visits to Malawi and Zambia respectively at the invitation of the Democratic Progressive Party of Malawi and the Movement for Multi-Party Democracy of Zambia.
The delegation, at the invitation of the Tunisian Constitutional Democratic Rally, will also attend the fifth national congress of the party as CPC representative.
The delegation, led by Vice Minister of the International Department of the CPC Central Committee Li Jinjun, will pay friendly visits to Malawi and Zambia respectively at the invitation of the Democratic Progressive Party of Malawi and the Movement for Multi-Party Democracy of Zambia.
The delegation, at the invitation of the Tunisian Constitutional Democratic Rally, will also attend the fifth national congress of the party as CPC representative.
Malawi inflation to soar above 7 pct forecast
Malawi's inflation rate in 2008 is likely to be "much higher" than the 7 percent forecast by the government, the African nation's finance minister told Reuters on Friday.
Malawi's economy, which had been enjoying a modest boom, has been buffeted this year by surging food and fuel costs. The country relies on agriculture, primarily tobacco, for its foreign earnings and is dependent on imported oil and gas.
"I think inflation would end up much higher than the seven percent projected because of the prevailing conditions," Finance Minister Goodall Gondwe said in an interview.
Gondwe said that other forecasts would also be affected by the food and energy shocks but did not provide details. Malawi's government has projected that the economy would grow this year by 7 percent, compared to 8 percent last year.
One of the poorest nations in Africa, Malawi has seen its economy expand due to good maize harvests, economic reforms and an increase in aid from Western nations and other international donors.
Inflation dropped into single digits in early 2007 for the first time in four years, fuelled by lower food prices. That prompted the central bank to continue cutting interest rates.
Malawi's economy, which had been enjoying a modest boom, has been buffeted this year by surging food and fuel costs. The country relies on agriculture, primarily tobacco, for its foreign earnings and is dependent on imported oil and gas.
"I think inflation would end up much higher than the seven percent projected because of the prevailing conditions," Finance Minister Goodall Gondwe said in an interview.
Gondwe said that other forecasts would also be affected by the food and energy shocks but did not provide details. Malawi's government has projected that the economy would grow this year by 7 percent, compared to 8 percent last year.
One of the poorest nations in Africa, Malawi has seen its economy expand due to good maize harvests, economic reforms and an increase in aid from Western nations and other international donors.
Inflation dropped into single digits in early 2007 for the first time in four years, fuelled by lower food prices. That prompted the central bank to continue cutting interest rates.
BECKY SET FOR MALAWI ADVENTURE
BECKY Dunphy is looking forward to an interesting and rewarding gap year when she heads off to Malawi next week.
The 16-year will teach English, maths and sports to orphaned children in a village within the Blantyre region.
Becky visited the area last year with members of the St Andrews Church youth group. She travels out on Tuesday, flying from Edinburgh with stops at Frankfurt and Johannesburg before the final leg to Malawi.
The trip is organised under the umbrella of the charity, Aquaid, and Becky has benefited from a number of grants by local companies which have paid for flights and essential malaria tablets.
Becky told the Herald: "I'm really looking forward to it although the thought of being away from my family for so long is quite scary.
"I've never been away from home for so long.
"However, what makes it a bit more comforting is spending time at the same village last year with my church.
"It means not everything will be new to me and many of the families and people I became friendly with last time are still there."
She continued: "I'll be teaching at a primary level but because many of the children have little time for school some of them can be up to 17-years of age.
"When teaching sport, I hope to take my interests of football and athletics and build on that."
The 16-year-old recently completed her fifth year at Arbroath High School and has applied for a physiotherapy course at university which she hopes to start on her return from Malawi in 2009.
It is planned that Becky's family and fellow church members will travel to visit and assist in the village during June of next year.
Becky will then return to Arbroath with her family at the end of July.
U.S. Doctors Create Network to Help Treat Pediatric AIDS in Malawi
In Malawi, where some 83,000 children are infected with HIV, a new program brings U.S. doctors to the East African country and encourages African doctors to set up practices in their hometowns, instead of leaving for more prosperous countries.
FRED DE SAM LAZARO, NewsHour Correspondent: In Malawi, 1 out of every 4 children dies before reaching age 5. Famine is chronic, and AIDS has left tens of thousands of orphans often in the care of struggling grandparents, like Robin Nangwandu.
Many children, like his grandson, McAnthony, are HIV-positive.
ROBIN NANGWANDU, Malawian Grandfather (through translator): I will continue working until I die. Don't have enough money to buy food stocks, just enough money to buy day-to-day. It's not easy to care for a kid who is HIV-positive, not easy to shuttle him back and forth to hospital.
FRED DE SAM LAZARO: Until recently, there were just two pediatricians for the entire public health system. Dr. Peter Kazembe was one.
How many children in this country, approximately, are HIV-positive?
DR. PETER KAZEMBE: Well, it's estimated at 83,000 children are HIV-positive.
FRED DE SAM LAZARO: ... 83,000 children, and to serve all of them, you had two pediatricians, essentially?
DR. PETER KAZEMBE: The two pediatricians, yes.
FRED DE SAM LAZARO: He says many Malawian doctors have left for more prosperous countries, like neighboring Botswana, Britain, and the U.S.
DR. PETER KAZEMBE: The issues are the same in all the countries in southern Africa certainly, you know, with salaries, poor salaries, poor working conditions. There's nothing more frustrating than knowing what you need to do, but not having the resources to do it.
FRED DE SAM LAZARO: Dr. Kazembe was hired to lead one American effort to bring health care resources to Malawi. Its center is a modern, American-style clinic, complete with 11 young American doctors.
Colorado native Chris Buck and colleagues came here soon after completing their residency. Each will spend at least one year rotating through this busy clinic and also in some Malawian public health facilities.
DOCTOR: Is he using his mosquito net every night?
Doctors decrease, HIV spreads
FRED DE SAM LAZARO: The Pediatric Aids Corps program is the brainchild of Dr. Mark Kline of the Baylor College of Medicine in Houston. He wanted to address both Africa's brain drain and its struggle with HIV.
DR. MARK KLINE: You know, obviously, a number of long-term solutions have to be put in place to encourage African doctors to remain in Africa and to bring back African doctors who have emigrated to the developed world. But while those fixes are being put in place, we can't afford to lose a generation of children to this epidemic.
FRED DE SAM LAZARO: With a grant from drug giant Bristol-Myers Squibb, Kline designed a program that pays doctors, like Omolara Thomas of New York, a stipend of $40,000 a year. It's a fraction of what they could earn at home, but the program also pays down up to $40,000 in student loan debt for each year of service.
DR. MARK KLINE: Half of the doctors that we have in the program could not have participated were it not for the student loan debt repayment provision, because they simply couldn't afford to do so.
FRED DE SAM LAZARO: Three years after it began, about 60 physicians have been placed in 11 African countries.
DOCTOR: So you want to come take a listen again, just listen to both lungs?
FRED DE SAM LAZARO: Their mission: treat patients, and more importantly train local providers on the front lines, like nurses and clinical officers, like George Mkwanda. He works with Yale medical graduate Saeed Ahmed at the Kwale Public Hospital.
DR. SAEED AHMED: So if you listen -- if you compare the left to the right, the right is quite decreased compared to the left, correct?
FRED DE SAM LAZARO: A key goal of the Baylor program, besides providing American doctors, is improving working conditions so the Malawian providers don't leave, so some who have left come back.
DR. PETER KAZEMBE: Well, a lot of people want to stay and work, but, you know, you have to provide them, you know, basics for them to survive comfortably.
FRED DE SAM LAZARO: The Baylor clinic offers its staff more comfortable wages by local standards and basics that are rare in the spartan public health care system: equipment that works, hygienic facilities and drugs. That was enough to bring Dr. Portia Kamthunzi home from the U.K., despite a big pay cut.
DR. PORTIA KAMTHUNZI: It's not just the money for me. It's the job satisfaction, as well. It's different from working with the government institute, because there's a lot of shortages of supplies, so it's different here. You have almost everything.
Working with HIV-positive children, I feel that I can relate to them better than other people who are coming from other countries, because, in a way, I know the culture. I know the kind of background that they're coming from.
Severe limits hamper medical care
FRED DE SAM LAZARO: Compared to medical care in the rest of Malawi, this clinic, with a pharmacy dispensing life-saving antiretroviral drugs, or ARVs, may be a luxury. But for the visitors, this is a culture of severe limits compared to the do-whatever-it-takes American system they trained in.
DR. CHRIS BUCK: I have one patient I can think of in particular that's a 17-year-old boy. He's pretty severely immune suppressed. He's been on ARVs for a long time. And he has a gastric tumor. And it's just kind of slowly killing him, unfortunately.
And I can think of so many things I could do for him in the states to improve his prognosis -- from diagnostic tests to different medicines -- and here, I'm really hampered and limited. I really find that to be distressing.
DR. OMOLARA THOMAS: I think every day you wonder and you say to yourself, when you're prescribing these medicines, what difference really is this going to make, you know? Really what they need is food.
FRED DE SAM LAZARO: Doctors Thomas and Ahmed say they expected a difficult adjustment, but still they weren't prepared.
DR. SAEED AHMED: I worked at a very high-acuity hospital in New York, Columbia. And if one patient died or two patients died in a week or a month, it would be a big deal. But we come here and during our time on the wards, we might have three or four patients die a day. And coming to terms with that and coming to terms with there being limits to what we can do for kids was shocking and hard.
FRED DE SAM LAZARO: Working in such conditions is a valuable lesson for American doctors facing rising health care costs at home, says Washington, D.C., physician and author Fitzhugh Mullan.
DR. FITZHUGH MULLAN, George Washington University: We cannot keep developing our own health care system at the rate we are, that every year or two it eats up another percent of our gross domestic product. And working abroad is an internship, a trial by fire in learning how to deal with constrained resources.
Now, obviously, on a very different level, but the principles, the issues that people learning global health and living global heath will bring home will not only be valuable globally, but they're going to be valuable in leading our country in the future.
FRED DE SAM LAZARO: Mullan has long advocated a much larger federal program like Baylor's. It would repay African countries for helping fill the U.S. doctor shortage, he says, and be a strong boost to the American image.
U.S. doctors seek work in Africa
DR. FITZHUGH MULLAN: There are battles for hearts and minds going on in Africa. China is very present. And sending doctors abroad, sending nurses abroad is partly a statement of what we are beyond Coca-Cola and other commercial enterprises.
FRED DE SAM LAZARO: There's no shortage of doctors who want to go. Baylor's Dr. Kline says, for every one chosen, he has to turn away two.
DR. MARK KLINE: I think most of them do it because they feel that AIDS in Africa is the challenge of this generation. This is a very highly idealistic group of young physicians, by and large, and they want to do something very meaningful straight out of their training. They want to have an immediate impact.
FRED DE SAM LAZARO: The young doctors say their Africa stint has been profoundly formative and likely not their last. Dr. Thomas is bringing it full circle in her family. Her parents are Nigerian immigrants to America.
DR. OMOLARA THOMAS: I've been involved with trying to develop hopefully a program with Nigerian, I guess you can say, expatriates to the U.S. and physicians there who at some point do want to come back to Nigeria and do want to work.
FRED DE SAM LAZARO: Maryland native Amy Sims plans to return frequently to Africa.
DR. AMY SIMS: I'm actually going back for specialist training in a couple months in the states. And specialists are something that are kind of few and far between here in Africa. And so I plan to use that to train African health workers and kind of pass on that knowledge. And so I always see myself coming back to Africa.
FRED DE SAM LAZARO: Amid all the poverty and suffering, they say, are rewards harder to measure, but just as meaningful, like sharing good news with young McAnthony's grandfather...
DOCTOR: He looks fantastic.
FRED DE SAM LAZARO: ... or like watching the teen club on the clinic grounds, knowing that, without this clinic, few of these patients would have survived to be teens.
FRED DE SAM LAZARO, NewsHour Correspondent: In Malawi, 1 out of every 4 children dies before reaching age 5. Famine is chronic, and AIDS has left tens of thousands of orphans often in the care of struggling grandparents, like Robin Nangwandu.
Many children, like his grandson, McAnthony, are HIV-positive.
ROBIN NANGWANDU, Malawian Grandfather (through translator): I will continue working until I die. Don't have enough money to buy food stocks, just enough money to buy day-to-day. It's not easy to care for a kid who is HIV-positive, not easy to shuttle him back and forth to hospital.
FRED DE SAM LAZARO: Until recently, there were just two pediatricians for the entire public health system. Dr. Peter Kazembe was one.
How many children in this country, approximately, are HIV-positive?
DR. PETER KAZEMBE: Well, it's estimated at 83,000 children are HIV-positive.
FRED DE SAM LAZARO: ... 83,000 children, and to serve all of them, you had two pediatricians, essentially?
DR. PETER KAZEMBE: The two pediatricians, yes.
FRED DE SAM LAZARO: He says many Malawian doctors have left for more prosperous countries, like neighboring Botswana, Britain, and the U.S.
DR. PETER KAZEMBE: The issues are the same in all the countries in southern Africa certainly, you know, with salaries, poor salaries, poor working conditions. There's nothing more frustrating than knowing what you need to do, but not having the resources to do it.
FRED DE SAM LAZARO: Dr. Kazembe was hired to lead one American effort to bring health care resources to Malawi. Its center is a modern, American-style clinic, complete with 11 young American doctors.
Colorado native Chris Buck and colleagues came here soon after completing their residency. Each will spend at least one year rotating through this busy clinic and also in some Malawian public health facilities.
DOCTOR: Is he using his mosquito net every night?
Doctors decrease, HIV spreads
FRED DE SAM LAZARO: The Pediatric Aids Corps program is the brainchild of Dr. Mark Kline of the Baylor College of Medicine in Houston. He wanted to address both Africa's brain drain and its struggle with HIV.
DR. MARK KLINE: You know, obviously, a number of long-term solutions have to be put in place to encourage African doctors to remain in Africa and to bring back African doctors who have emigrated to the developed world. But while those fixes are being put in place, we can't afford to lose a generation of children to this epidemic.
FRED DE SAM LAZARO: With a grant from drug giant Bristol-Myers Squibb, Kline designed a program that pays doctors, like Omolara Thomas of New York, a stipend of $40,000 a year. It's a fraction of what they could earn at home, but the program also pays down up to $40,000 in student loan debt for each year of service.
DR. MARK KLINE: Half of the doctors that we have in the program could not have participated were it not for the student loan debt repayment provision, because they simply couldn't afford to do so.
FRED DE SAM LAZARO: Three years after it began, about 60 physicians have been placed in 11 African countries.
DOCTOR: So you want to come take a listen again, just listen to both lungs?
FRED DE SAM LAZARO: Their mission: treat patients, and more importantly train local providers on the front lines, like nurses and clinical officers, like George Mkwanda. He works with Yale medical graduate Saeed Ahmed at the Kwale Public Hospital.
DR. SAEED AHMED: So if you listen -- if you compare the left to the right, the right is quite decreased compared to the left, correct?
FRED DE SAM LAZARO: A key goal of the Baylor program, besides providing American doctors, is improving working conditions so the Malawian providers don't leave, so some who have left come back.
DR. PETER KAZEMBE: Well, a lot of people want to stay and work, but, you know, you have to provide them, you know, basics for them to survive comfortably.
FRED DE SAM LAZARO: The Baylor clinic offers its staff more comfortable wages by local standards and basics that are rare in the spartan public health care system: equipment that works, hygienic facilities and drugs. That was enough to bring Dr. Portia Kamthunzi home from the U.K., despite a big pay cut.
DR. PORTIA KAMTHUNZI: It's not just the money for me. It's the job satisfaction, as well. It's different from working with the government institute, because there's a lot of shortages of supplies, so it's different here. You have almost everything.
Working with HIV-positive children, I feel that I can relate to them better than other people who are coming from other countries, because, in a way, I know the culture. I know the kind of background that they're coming from.
Severe limits hamper medical care
FRED DE SAM LAZARO: Compared to medical care in the rest of Malawi, this clinic, with a pharmacy dispensing life-saving antiretroviral drugs, or ARVs, may be a luxury. But for the visitors, this is a culture of severe limits compared to the do-whatever-it-takes American system they trained in.
DR. CHRIS BUCK: I have one patient I can think of in particular that's a 17-year-old boy. He's pretty severely immune suppressed. He's been on ARVs for a long time. And he has a gastric tumor. And it's just kind of slowly killing him, unfortunately.
And I can think of so many things I could do for him in the states to improve his prognosis -- from diagnostic tests to different medicines -- and here, I'm really hampered and limited. I really find that to be distressing.
DR. OMOLARA THOMAS: I think every day you wonder and you say to yourself, when you're prescribing these medicines, what difference really is this going to make, you know? Really what they need is food.
FRED DE SAM LAZARO: Doctors Thomas and Ahmed say they expected a difficult adjustment, but still they weren't prepared.
DR. SAEED AHMED: I worked at a very high-acuity hospital in New York, Columbia. And if one patient died or two patients died in a week or a month, it would be a big deal. But we come here and during our time on the wards, we might have three or four patients die a day. And coming to terms with that and coming to terms with there being limits to what we can do for kids was shocking and hard.
FRED DE SAM LAZARO: Working in such conditions is a valuable lesson for American doctors facing rising health care costs at home, says Washington, D.C., physician and author Fitzhugh Mullan.
DR. FITZHUGH MULLAN, George Washington University: We cannot keep developing our own health care system at the rate we are, that every year or two it eats up another percent of our gross domestic product. And working abroad is an internship, a trial by fire in learning how to deal with constrained resources.
Now, obviously, on a very different level, but the principles, the issues that people learning global health and living global heath will bring home will not only be valuable globally, but they're going to be valuable in leading our country in the future.
FRED DE SAM LAZARO: Mullan has long advocated a much larger federal program like Baylor's. It would repay African countries for helping fill the U.S. doctor shortage, he says, and be a strong boost to the American image.
U.S. doctors seek work in Africa
DR. FITZHUGH MULLAN: There are battles for hearts and minds going on in Africa. China is very present. And sending doctors abroad, sending nurses abroad is partly a statement of what we are beyond Coca-Cola and other commercial enterprises.
FRED DE SAM LAZARO: There's no shortage of doctors who want to go. Baylor's Dr. Kline says, for every one chosen, he has to turn away two.
DR. MARK KLINE: I think most of them do it because they feel that AIDS in Africa is the challenge of this generation. This is a very highly idealistic group of young physicians, by and large, and they want to do something very meaningful straight out of their training. They want to have an immediate impact.
FRED DE SAM LAZARO: The young doctors say their Africa stint has been profoundly formative and likely not their last. Dr. Thomas is bringing it full circle in her family. Her parents are Nigerian immigrants to America.
DR. OMOLARA THOMAS: I've been involved with trying to develop hopefully a program with Nigerian, I guess you can say, expatriates to the U.S. and physicians there who at some point do want to come back to Nigeria and do want to work.
FRED DE SAM LAZARO: Maryland native Amy Sims plans to return frequently to Africa.
DR. AMY SIMS: I'm actually going back for specialist training in a couple months in the states. And specialists are something that are kind of few and far between here in Africa. And so I plan to use that to train African health workers and kind of pass on that knowledge. And so I always see myself coming back to Africa.
FRED DE SAM LAZARO: Amid all the poverty and suffering, they say, are rewards harder to measure, but just as meaningful, like sharing good news with young McAnthony's grandfather...
DOCTOR: He looks fantastic.
FRED DE SAM LAZARO: ... or like watching the teen club on the clinic grounds, knowing that, without this clinic, few of these patients would have survived to be teens.
Malawi cell group to spend $28m on network upgrade
Malawian mobile phone network operator TNM says it has set aside $28-million for the upgrading and expansion of its network in order to boost the quality of services and reach out to the rural areas of the Southern African country, which currently do not have access to mobile telecommunication services.
TNM, one of two cellular network operators in Malawi, is owned by a consortium whose major shareholder is Malawi's landline service provider, Malawi Telecommunications Limited (MTL), which, in turn, is owned by a consortium Press Corporation, as an equity partner, German's Detecon, as a technical partner, and South Africa's Standard Bank and Development Bank of Southern Africa, as financial partners.
TNM chief technical officer David Chetty says: "Our interest is to increase penetration by catering for the rural areas, which, currently, do not have access to cellphone services."
At 7%, Malawi has one of the lowest cellular-phone penetration rates in Africa. International research indicates that an additional 10% of mobile penetration leads to 1,5% increase in growth domestic product.
TNM and Celtel Malawi, a subsidiary of pan-African mobile network operator Celtel, share about 1-million active mobile-phone service subscribers in Malawi, which has a 12-million-strong population.
However, the Malawi government advertised for a third mobile network operator last year but has yet to grant a licence, despite receiving bids from five companies, with South Africa-based Econet Wireless and US-based Millennium Global Telecom seen as the frontrunners.
The Malawi government is also receiving applications from firms wishing to operate a fourth mobile network firm in the southern African country .
In order to ensure universal access to telecommunications facilities in the impoverished southern African country, the Malawi government has also just scraped import tax on mobile handsets.
TNM, one of two cellular network operators in Malawi, is owned by a consortium whose major shareholder is Malawi's landline service provider, Malawi Telecommunications Limited (MTL), which, in turn, is owned by a consortium Press Corporation, as an equity partner, German's Detecon, as a technical partner, and South Africa's Standard Bank and Development Bank of Southern Africa, as financial partners.
TNM chief technical officer David Chetty says: "Our interest is to increase penetration by catering for the rural areas, which, currently, do not have access to cellphone services."
At 7%, Malawi has one of the lowest cellular-phone penetration rates in Africa. International research indicates that an additional 10% of mobile penetration leads to 1,5% increase in growth domestic product.
TNM and Celtel Malawi, a subsidiary of pan-African mobile network operator Celtel, share about 1-million active mobile-phone service subscribers in Malawi, which has a 12-million-strong population.
However, the Malawi government advertised for a third mobile network operator last year but has yet to grant a licence, despite receiving bids from five companies, with South Africa-based Econet Wireless and US-based Millennium Global Telecom seen as the frontrunners.
The Malawi government is also receiving applications from firms wishing to operate a fourth mobile network firm in the southern African country .
In order to ensure universal access to telecommunications facilities in the impoverished southern African country, the Malawi government has also just scraped import tax on mobile handsets.
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