1. Where I am Coming From
I was bornin Savannah,Georgia,before integration andairconditioning. Myfamilywasamongthe
1% of Georgianswhoare Catholic. I wasthe fourth, middle childof afamilyof sevenchildren. Both
my parentssufferedthe lossof theirfathersduringtheirchildhood,sogrew upduringthe
Depressionunderlessthanthe bestcircumstances.
As a pre-school childinSavannah,Istayedhome withmymother. Mothercleanedhouse and
washedmostof the day,itseemed. She wasraisedbya womanwhowas a frustratedVaudeville
performerwhomarriedaJewishdepartmentstore ownerinAugusta,Georgia, andhadfive children,
all girls. Possiblybefore anddefinitelyafterherhusbanddied,myGrandmotherSylvesterusedher
daughterstoredresssome of her frustrationsasa performer. She taughtthemtosing,dance,and
act from earlyintheirlives. She wrote playsandmusicalsforthem, made costumesandstage sets,
and arrangedwithvacationhotelsinAugustaforherfamilytoprovide entertainmenttoNortherners
whohad traveledtoAugustatoescape the winter. Evidently,the Sylvestersperformedfrequently.
Otherstrange experiencesfromSavannahwere runningformonthsonthe tar-pavedstreetand
encounteringthe fog-sprayingtrucks. Duringthe warmermonths,all Iwore were small,cotton
shorts. My brothers,neighbors,andIwouldplaygamesonthe pavedstreets,clearingoff whena
vehicle came. One of mymemorieswaslookingatthe solesof myfeetwhile bathingas a young
child. I couldnotunderstandwhymysoleswere black. IfurtherreflectedthatBlackshadpaler
solesandI had blacksoles. Howsurprising! Anothermemorywasridingmybike withothersinthe
evening. Truckscame throughwithlarge tankson the back, sprayingoutwhitishfogs. We kids
founditveryfunto see howclose we couldget to the trucks,ridinginthe fog. It neveroccurredto
us that the trucks were spraying DDTfog thatkilledmosquitoesandthatwasstoredinthe bonesof
otherlivingcreatures. The driversneversaidanythingandnosignswere displayedonthe trucks.
WhenI was eightyearsold,myfamilymovedtoStatesboro,Georgia. There were noCatholic
schools,the Catholicpopulationinthe small townbeinglessthan1%, so I was enrolledinapublic
school. The teacherswere all committedandseemedgood. Ithankthemfor my basicliteracyand
numeracy. Afterschool,Iwasalmostneverinvited tootherstudents’houses,nevertobirthday
parties,andnevertoany sort of outing. It seemednatural tome. It neveroccurredto me that most
studentswere eitherBaptistsorMethodistsandmostactivitieswerechurch-centered.
Beingtreatedasan outsider,Ieitherbaby-satformyyoungerbrothersorplayedinthe forests,
streams,ponds,andswampsaroundus. Caringfor mybrothersgave me a sense of purpose. The
forests,swamps,andstreamsgave me an experience of delight. Icouldwanderinthe woodsfor
hours,swingontreesacross streams,andplaywithMother Nature. I neverfeltlonely.

2. AnotherthingthatI didwas read. Mother and Dad had the Harvard JuniorClassics,thathe inherited
fromhis Mother. Mother wouldbuybooksthatshe thoughtwouldbe goodfor us fromsalesmen
whocame to the house. She boughtbooksof fairytalesanda Catholicseriesof livesof the saints.
WhenI had time,Iwouldcuddle upwiththese booksandreadforhours,until I had readthemall.
In the fifth orsixthgrade,my brothertookme to the town librarytoget a librarycard and showed
me hisfavorite books,like “SwissFamilyRobinson”andothers. Iread themall. As a consequence,I
developedbothaminimal vocabularyandasense of grammar,allowingme todo well inmyEnglish
and historyclassesthroughoutschool.
My fatherwasa story-teller,likemanyGeorgians. He toldstoriesof hisyouth,tellingmanyof the
storiesmanytimes. Iheardof hisyouth,mymother’syouth,andsome aboutmy birth.
My father’smotherwasa German-AmericanLutheran,maybe asecond-generationAmerican,who
boughta house on Main StreetinAugustawhenherhusbanddied. She boughtatwo-storyhouse,
one floorto rent,one floorto raise herfourchildrenandto cookmealsfor herboarders. She wasan
inveterate,accomplishedcook. She made whippedcreamtoppingsforcakesandpastries,
blackberryjamand wine,anddelicioushigh-cholesterol meals. She alsowasanaccomplished
seamstresswhomade herchildren’sclothesfromscrapsandre-designedoldclothes. Myfather’s
fatherdiedwhenmyfatherwasfouryearsold. My fathertoldme many timesthathismothercame
to him,a fouryear-old,uponhisfather’sdeath,heldhimbyhislapels,andtoldhim, “Albert,now
youare the man of the family.” My fathertookcare of hisfamilieseversince.
Dad was lessracistthanmany Southerners. Onthe one hand,he toldme how he dove intothe
SavannahRiverandsaveda youngBlack youthwhenhe wasa boy. On the other,he complained
aboutMartin Luther Kingleadingmarchesinthe Sixties. Once,whenIwasabout20, he toldme not
to bringa Black womanhome to marry because he wouldhave todis-ownme. Unfortunately,none
everseemedattractedtome and I hadno ideahow to meetandwoo anyone.
As a youngchildandthroughoutmy elementaryandhighschool years,Icame to believethatBlacks
were beingcheatedbythe system,butIneverhadany insighthow todo anythingaboutit. My first
experience waswithone of ourmaidsinSavannah. As a preschooler,once Iaccompaniedherto
downtownSavannah. Justthe twoof us traveled,she leading. We caughtthe trolley. We goton
and proceededtothe rear,to the onlyseatsBlackswere allowedtositin. What inthe worldwas
this,I thoughtto myself.
Althoughwe were notwell off,we hadpart-timemaidsmuchof the time while Iwasgrowingoff. I
wouldworkwiththem,observe them, converse withthem, andlearnfromthem. Ithoughtone,Ms.
BettyJeanKing,was particularlyintelligentandinsightful. Iwas amazedbythe systemsshe usedto

3. cleanoff the table and cleanthe house. Ilovedtalkingwithherandlisteningtoher. I wentwith
Mother to drive herhome aftershe helpedusandsaw where she livedwithheryoungchildrenand
husband. Afterintegration,BettyJeanwentbacktoschool and got a nursingdegree. Ibelieve she
was killedinademonstrationabout1980. I was shocked.
In Statesboro,myfamilylivedonone side of the railroadtracks. A Blackcommunity,“Whitesville,”
was onthe otherside. Ourside hadstreetlights,large houses,pavedroads,electricity,streetlights,
water,and sewer. Whitesvillehomesweresmall totiny,moderatelyattractivetodilapidated,
sometimesheatedbywoodburningstoves,onunpavedroads,presumablywithoutsewersystems.
No busesranfrom townto Whitesville. Once,while drivinghome,Isaw an elderlyBlackwoman
carryingher groceries,walkinghome inarainstorm. I stopped,pickedherup,anddrove herto her
house. Itlookedlike itwasabout8 feetwide by12 feetlong. Ithad neveroccurredto me we had
builta systemthatforcedBlacksintosuch livingconditions. Whatweighedmostonme wasthat I
neverfiguredouthowtosupportthemintheirstrugglesforequal treatment.
Dad didjoinMotherin workingforinter-racial understandingandharmonyinStatesboro,wherewe
livedfromthe time Iwas eightyearsoldon. At the same time,he ran a businessthatapparently
hiredBlacksonlyforunskilledlaborpositionsandpaidthemthe minimumwage.
As a consequence,Motherknew manysongsandwasan accomplishedsingerusedtobeinginthe
limelight. Whilevacuumingthe livingroom, she wouldputonthe musicof GilbertandSullivan’s
“Three Little MaidsfromSchool are We” and otheroperasandsingalong while vacuuming. I
rememberlyingdownbythe vacuum,enjoyingitswarmexhaust, andlisteningtoMothersing.
Althoughwe were poorformuchof my childhoodandlivedina1100 square foot house,bothmy
parentshad college educations. DadgraduatedfromGeorgiaTech as an electrical engineerand
servedinthe army as an officer. MotherattendedGeorgiaWomen’s College forayearafter
graduatingfrom AugustaJuniorCollege. Motherhadbeenvaledictorianof herhighschool and
juniorcollege. She alsosaidshe had beenthe bestLatinstudentinGeorgia. She had a prodigious
short-termrecall memory. Isaythat because Ineverheardof her studyingbefore she completed
herundergraduate andgraduate degreesinherfifties. Inhighschool andcollege,she reputedly
attendedclassandplayedtennisordatedafterschool,neverstudying. Dad’ssister,Catherine,a
veryhard-workingstudent,complainedtoDadaboutMother beatingheron examsdespite her
havingbeenonthe tenniscourtsplayingorout withDad ona date at all hours.
Dad, on the otherhand,toldus childrenstoriesabouthisfocusingongivinghisteachersworkthat
wouldbe scored70, nomore andno less. The moral of hisstorieswasthat he had beentoldthat70
was passing,sohe thoughthe shouldnotgive more thannecessary. He said if he figuredhe had

4. made 70 on a test,he wouldstopworkingonitand turn itin. He also continually workedjobsafter
school fromthe time he was five yearsold,buthisworkethicinschool was differentfromthaton
the job. Ineducation,he saidhisconclusionwasthathe shouldgive nomore than necessary. At
work,he toldus that we had to give ouremployersmore thantheyexpected.
Possiblyasa consequence of bothMother’sandDad’sstoriesabouttheireducationandtheir
experiences,Ineverstudiedoutsideclassnorbroughta bookhome fromschool until the ninth
grade. I did well inschool because Ipaid attentionandquicklylearnedwhatwastaught,butInever
learnedanydiscipline until the ninthgrade. Inthe ninthgrade,however,IenrolledinSt.John
VianneyMinorSeminaryinSavannah,Georgia,tobeginstudiestobecome aCatholicpriest. All of
my teacherswere priests. Ilivedindormitoriesatthe seminary. Iwassurprisedbya few things.
We hadto go to studyhall in the eveningsafterclasses. Inthe firstfew weeks,afterfinishingmy
assignments,Ipulledoutanovel toread. One of the priestsreprimandedme,explainingthatIwas
supposedto study until studyhall endedat9:30 PM. What a concept! Anothersurprise wasthat
once,I passedmyalgebrahomeworkforwardwhenthe priestrequestedit. The seminarianinfront
of me erasedmyname and filled inhis. Iwasshocked! Anothersurprise wasthat one of the
studentsbroughttrapsfromhome and trappedopossums,raccoons,andfishinthe Savannah
marshlandsaroundthe seminary. Trappinghadneveroccurredtome. The seminarywasa pleasant
environmentunlike anyIhadeverimagined.
The seminarygave me a totallynewperspective onschool. Studentswere supposedtobringlessons
home fromschool,study,andprepare forthe nextday. Teacherswere supposedtoteach. Students
were supposedtobe quietandpayattentioninclass. AfterbeingastudentinStatesboro,who
wouldhave imaginedsuchasituation?
Afterone yearat the seminary,one of myolderbrotherswhohadalreadybeenaseminarianforfive
yearsand wasstill inthe seminary,toldme thatI shouldlive inthe normal populationanumberof
yearsbefore becomingaseminarian,soIdroppedoutafterthe ninthgrade and returnedto
StatesboroHighSchool andlivingathome. Unfortunately,Ididnotlose the habitsandattitudesI
had learnedatthe seminary. Forinstance,whenmytenthgrade Latinteacher didnot begin
teachingLatinuntil the thirdweekof school,Iaskedherwhenwe wouldstartto studyand learn
Latin. Whenshe toldme that Latinwas a deadlanguage that wasno longerwritten,spoken,orread
and that,therefore,all we woulddowaslearntwentyEnglishwordswithLatinrootsperweek,Iwas
astonished. Since she wasnotgoingtoteach mostof the time andwouldjusttell storiesthatshe
had notresearched,Igot out booksfromothersubjectstostudywhile she regaledusabouther
beliefsabouteducation inChina. She stoppedme fromstudyingandmovedme tothe frontof class
where she couldkeepaneye onme and make sure I onlypaidattentiontoher. I complainedtomy
Fatherthat the teacherwas abusingherpositionandnotcomplyingwithherresponsibility. He told
me she was the teacherand therefore Ihadto show herrespectregardlessof whatshe did. That did
not sitwell.

5. An Englishliteratureteacherinthe eleventhgrade wassomewhatmore committedtoperforming
herduties. However,when she sawaword,maybe “Alhambra,”andpronounceditwithfour
syllables,Iaskedherif that were the correctpronunciation. She askedif Ihadlookeditup,to which
I replied,“No,”havingbeentoldinthe seminarynevertopointoutwhenmyteacherswere wrong. I
lookedupthe word’spronunciation,putupmyhandagain,and thistime informedherwhatthe
pronunciationwas. She wasindignant.
An Americanhistoryteachermade assertionsaboutthe VietnamWar,Sherman,andother
information,welcoming ourdiscussion. Ithoughthisassertionsfrequentlywere preposterousand
contestedthem. Iwasusuallyappalledbyhislogic.
By the endof the 11th
grade,it wasapparentto my parentsthat I wasextremelyfrustratedwithhigh
school educationasit wasdone inmy highschool inStatesboro. Iwas recommendedtothe
Governor’sHonorsProgrambut didnot getin. WoodwardAcademymailedall studentswhowere
not acceptedaninvitationtoa paidalternate experience afterthe 11th
grade. I attended,enjoyed
my teachers,andwasinvitedtobecome apayingstudentmysenioryear. My Fathersaidwe didnot
have the money. One of my teachers,CleoHudson,offeredforme tolive withherfamily,the school
offeredasmall scholarship,andmyFatheragreedforme to attend.
My aspirationsgrewwiththisexperience of abetterqualityof education. IappliedtoHarvard,
Notre Dame,Vanderbilt,the Universityof Georgia,andthe AirForce Academy(atmy brother’s
suggestion),andwasacceptedtoall exceptHarvard.
WhenI showedmyacceptancestoDad, he saidthat if I wenttoany place otherthan the AirForce
Academy(whichwasfree),Iwouldhave toborrow moneyandpaymy way. He couldnot helpme. I
decidedtogo to the AirForce Academy,havingnoideawhatI was signingupfor.
In June,1967, I caught a commercial flighttoColoradoSpringsthroughDenver. A buspickedme up
and tookme to a local hotel forthe firstnight. The nextday,an Air Force Academybuscame to the
hotel andpickedupme and the other new cadets,deliveringusabout15 milesawaytoa very
impressivelookingcampuswithsoaringchurchsteeplesonthe highplainwithaback-dropof the
Rocky Mountains. We were ledintoa large auditoriumandgivenanhourlongspeechonwhat to
expect,under-scoringthatwe shouldsuspendjudgmentforthe firstyear. Itook the speaker
seriouslyandsuspendedjudgment,planningtodraw conclusionsthe nextyear.

6. We were ledoutof the auditoriumandtoldto forma longline. The line ledthroughthe Academy
store,where we receiveduniforms,shoes,boots,athleticclothes,belts,ties,andcoats,all of which
were loadedinbigduffle bagswe carried. Itwentthroughthe barbershopwhere we were given
haircutsby havingthe electricshearspressedhardagainstourscalpsandrun overeveryinchof our
hairlines. While carryingourbags,we were approachedbymedical corpsmenwithvaccine power
injectorsandgivenshotsinourarms. We continuedinline withblooddrippingdownourarms.
Finally,we were dividedoff andtakentoour summersquadronsandassignedroomswithfour
cadetsper room,twinbunkbeds,anda wash standin the room.
Thenthe seriousbasictrainingbegan. We receivedsome atthe Academydorms. We receivedmore
infieldtentsawayfromthe Academyitself. There were obstacle courses,marchinginranks,
runninginranks carryingM-1 rifles,climbingropes,crawlingthroughmudandunderbarbedwire
constructions,andexercisesinthe fields. A minorproblemoccurredinthatour headshadbeen
shaven, the airwas dry,the sun wasbright,the altitude washighandthe atmosphere thin,andwe
spenta lotof time inthe fieldwithnohatson our heads. Many of my classmatesgotburned,
blisteredscalps. Afterafewdaysof that, we were all issuedbaseballcapsthatwe wore from then
on.
Some of the thingsthatsurprisedme follow. One wasthatwe were toldthat we were the peace
keepersof the worldandwe didthat by beingthe fastest,mostdevastating,most horrible killing
force in the world. Equatingpeace withtrainingtokill wasatroublingconcepttome. It made no
sense. Anotherthingwasthatwe ran inranks, information,andwere toldtoneverbreakstepor
formation,sowhenone of mysmallerroommateshyperventilatedwhilerunningandpassedout,
anotherof my roommates(afootball player) whowasthe otherguy’sbestfriendtrampledhimsoas
not to breakranks. I was shocked. Again,anotherof myclassmatesfrequentlycouldnotmake the
full distance of ourruns andwoulddropout of formation. The upperclassmenwhowere ourdrill
masterswouldthengangup on himandyell at him, make himdouncomfortable exercises,and
require himtoshowup foradditional torture. Whenhe (orany of us) was askedwhyhe failed,the
onlyresponse thatwasallowedwas“Noexcuse,Sir!” A few weekslater,whenhe learnedhow togo
to the Academymedical clinic,itwasfoundthathe had a legfracture. Thistrainingmethodology
seemeddysfunctional,butI hadbeentoldtoreserve myjudgment. Anotherillogical conceptIwas
introducedtowasthat the Academytookus, amongthe betterstudentsandathletesfrommany
schoolsall overAmerica,andproclaimedthatitintendedto“breakusall down”and then“rebuild
us” to the Academy’sstandards. Icouldunderstandwhythe Academywouldbreakdown
dysfunctional practicesandconcepts,butitmade no sense todestroygoodones,butI had beentold
to reserve judgment. Later,we receivedorientationsfromanofficerwhohadbeena prisonerof
war inthe KoreanWar. He toldus thathe had beensubjectedtobrain-washingandhow brain-
washingworked: itinvolvedbreakingdownthe prisonersthenbuildingthembackupin Communist
values. The parallelismbetween whatthe Academydidandwhatthe NorthKoreansdidshocked
me,but I wasreservingjudgment.

7. Thenthere wasthe experience of marchinginrankstothe impressive Academychapel everySunday
and listeningtoourchaplainstell uswhatto do inservice of God. I alsowentto eveningstudy
groupswiththe chaplains. Once,a chaplainrespondedtomy positedquandarysupposingIwere
stationedinAnchorage andMartinLuther Kingcame throughand was preachingacrossthe streetat
the Baptistchurch at the same and onlyhourthat the CatholicSundayservice was. Ifurther
supposedthatthe Catholicpriestgave dead,uninspiringsermonsandsaidthe Mass in the speed-
readingmannersome priestsused. Iaskedif itwouldnotincura mortal sinto skipMass and listen
to the more inspiring,provocative ReverendKing. The chaplainrespondedinhorrorthatI evidently
“didnot have the giftof faith.” That setme to wonderinghow desirable the giftof faithwas,
especiallyforofficersinthe military.
The Academydida fewotherdysfunctional thingsincludinghavingcross-countryrunners (Iwas
one),afterrunning18 miles,havingtoimmediatelychange clothesandmarchin formationtothe
dininghall andeatunderoppressive conditions,sittingatattentionandbeingdrilledwhile
supposedlyeating,restrictedtothree chewsbeforeswallowing,beforeourbloodhadbeenable to
returnfrom ourlegsto supplyourintestines. Asaconsequence,Icontinuallylostweight,dropping
from166 to 132 pounds. Iaskedmyself,whatare theythinking? Additionally,we hadoursleep
restrictedto7 hoursper night, regardlessof how muchexercisewe did. Whatwere theythinking? I
reservedjudgment.
As a Junior,Iwas toldto impose onnewcadetsthe methodsthatI had beensubjectedto. That
troubledme. Addingthe ideaof achievingpeace throughtraininginviolence andbreakingdown
newcadetsregardlessof the desirabilityof theirpractices,apparentlyusingthe methodsof brain-
washing,troubledme more. Istartedgettingjaundicedinmyfeelingsaboutthe Academyandits
practicesand becomingextremely sarcasticwhenaskedanyevaluativequestionaboutwhatwe
cadetsdidor what our nationwasdoinginVietnam. Itwas time tosubmitmyrequesttoresign,
whichI didearlyinthe secondsemesterof myJunioryear.
I was givenamedical disabilityretirementfromthe Academy. Ihad expectedtobe forcedtobe an
airmanfor three years. I had forgottenthatwhenIshatteredmyankle duringmysophomore year
and the orthopedicsurgeonhadbarelybeenable tosave itthathe had mentionedthathe could
bothkeepme inthe Academyorget me out if I wanted. The Academysentme to himformy first
medical examinationandsuddenlyIwaswithdrawnwithoutfurthermilitaryobligations.
What surprisedme afterthatwere twothings: one,I suddenlywasphysicallyverystrongandhad
virtuallynofearof anything;two,Ihad no commitmenttostudyanymore. Thatwas problematic
whenI transferredtothe Universityof Georgiaandenrolledinitshardestcourses,overloading.

8. I came to believe andconclude manythingsfromthese developmental experiences,thingsthatI
tookto Guatemalaas a Peace Corps Volunteer. One wasthatthere were abusive elementstothe
Americansystem,elementsthatI,forthe most part, wasnot subjectedto. Anotherwasthat we
were supposedtostudyhardand workhard, and,if we did,we wouldbe handsomelyrewarded.
Anotherwasthat learningandlivingcame easily. Fromthe Church,I hadlearnedthatwe were
supposedtobe decentandcaring and thinkof the goodof others. From myfamily,Ihad learned
that we wouldlove andsupportone anothernomatterwhat. Fromwhere I grew up,I had learned
that the environmentwasenjoyable,pleasant,consoling,andbeautiful. Frommyexperience with
the Americansystem,Ihadlearneditwas basicallybenevolenttowardthe majorityof the
populationandthatthere wasa sense of laws,fairness,anddecency. These Leibnizianideas and
Pollyannaishthinking,despite contradictoryrealitiesandexperiences, were those IhadwhenI
joinedthe Peace Corpstoworkin Guatemala. How well wouldtheyserve me?

9. Surprises in Guatemala
I was inmy 9 foot high,10 by 16 foot roomnextto the tienda(small store) one nightinMarch1974,
listeningtothe GuatemalanPresidential electionreturnoverVoice of Americaonmy short-wave
radio. At 8 PM, the firstreturnscame in. The hand-selectedsuccessorsof President/General Arana,
Kjell andMario(General Kjell),werenotwinning! Thiswasunheardof andunexpected. Shocking
for sucha controlledgovernment. RiosMontt(Colonel) waswinning! Astonishing.
9 PM: Rios Montt increasedhislead.
10 PM: Montt’sleadcontinued!
11 PM: All national mediawere shutdown. Newspaperswereclosed. TV stationswere closed.
Radiostationswere closed. Whatwasthisall about?
Midnight: everythingremainedclosed. Noannouncements.
1, 2, 3, 4, 5, 6, 7 AM: Nonews. Noannouncements. The national mediawere all closed.
8 AM: The newswasback on! Astoundingly,KjellandMariohad wonthe electionbyanexceedingly
small margin. Can youbelieveit?!
No,not really. Thiswasa differentslantonpoliticsandpublicrelationsthanIhad everseen,more
thinlyveiled,more blatant. Itrockedme.
Guatemalawasfull of shocksto my Americansense of propriety. The rulingclass,predominantly
Generals,usuallytrainedinthe FortBenning,Columbus,GA School of the Americas,apparently
couldcare less.
For instance, anothershocktomy perceptionoccurred one nightasI ate my dinnerof corn tortillas
and blackbeans,same as the thousandsinmyvillage andmostof eightmillionGuatemalansand
hundredsof millionsof Central andSouthAmericansandAfricans, Ilistenedtothe US Secretaryof
Agriculture,Earl Butz,talkoverthe Voice of America(VOA). SecretaryButzexplainedthatthe

10. decline of cornproductionthatyearhad nothingto dowiththe worldfoodsupply. Cornwas justa
livestockfeed. Itookanotherbite of my corn tortillaand “chewed”thatover.
Guatemalarockedme manydays of my two yearsthere,from1973 to1975. I wastoldthat one
village hadobjectedtothe financial systeminwhichsmall,local storesinsistedthatthe highland,
indigenousfarmersreceive theirpurchasesoncredit. Then,shortlybeforeharvestof crops,the
storeswouldinsistre-paymentof the creditandinformthe farmersthatthe credithadbeenat 3% a
month. Whenthe farmersexplainedthattheycouldnotpay until theircropscame in,the stores
wouldsell the farmers’ debttolaborcontractorsfor coastal plantations. The laborcontractors
wouldsendopen-decked,flatbedtruckswithwoodfencesaroundthe freightbedtocollectthe
farmers. The farmers,accustomedanddressedtolive andworkat 6,000 feetaltitude ormore
where the average daytime temperature wasabout70 degreesFahrenheit,wouldbe herdedonto
the truck, crowded,andshippedtothe hot,muggycoast. There,theywouldbe putinlarge,tin
dormitoriesandforcedtoworkoff theirdebtsinthe fields. Since the plantationownershadno
responsibilityforthe healthof the workers,insecticide andfungicide planesthatsprayedthe crops
were allowedtosprayregardlessof whetherthe farmerswere inthe fieldornot. Livingconditions
were crowdedanddifferentfromthe altiplano (highplain). Farmerworkerssuffereddiarrheaand
fevers. Sometimestheydied.
A village hadcomplainedaboutthispractice tothe departmental governor. He agreedtomeet
themintheirtownsquare at a certainhouron a certainday. That day, the farmerswhoobjectedto
the practice,one similarto the US outlawedpractice of debtors’prison,assembledinthe square.
Imagine theirsurprise whentroopsclosedinfromall directionsandopenedfire onthem!
Once,I listenedtoaUS-educatedGuatemalanexplainabouthispayingtaxesinhiscommunity. He
saidhe receivedabill,sohe wentto the municipalitytopayit. Whenhe pulledouthischeckbookto
pay,he wastoldto waitand another,higher bill wasproducedtoreplace the first. Whenhe started
to pay that,the processwas againcompleted. He wasnot allowedtopayhisbill. Outside,he was
surreptitiouslyinformedthatwhatone doesispay a fixer. Whenhe wenttothe fixer,the bill was
much lower;however,the paymentwasoff the recordsandthe fixerandthe bill collectorwere able
to keeppartof the payment. Theyhadto live thiswaybecause the salariesof civil servantswasso
lowand theirpaymentsoerratic. You justhad to understand.
In case I didnot believethatstory,Iunintentionallyreceivedsomeverification. AsPeace Corps
Volunteers,we hadbeentoldthatwomenonlywore dressesandbelow the knee skirts. Theydid
not wearslacksand definitelynotblue jeans. Once mywife andI arrivedinGuatemala,we learned
that actually,inrural areas,one did wearjeans. My wife wrote tohermotherand had three old,
wornpairs of jeansmailedtoher.

11. We receivedanote thatwe had a package inCustoms. I wentwiththe receiptandmypassportto
Customs. Asa Peace CorpsVolunteer,Ihadbeentoldthatall shipmentswere dutyfree forthe first
90 days in-country.
Customswasa bigwarehouse inGuatemalaCity,the capital, withlotsof cubbyhole officesalongthe
outside walls. Iwentaroundaskingdirectionsandfinallyarrivedatthe rightoffice. Ishowedmy
receiptandmy Peace Corpsletterandaskedforthe package. I wastoldthe costwas $30. I
explainedthe agreementwiththe government. The officialre-iteratedthatIhad to pay$30. I
refusedandwentbackto the Peace Corpsoffice andwas toldthat I hadthe rightto the package
duty-free. Igot more documentationandreturned. Iwastoldthe cost was now $40. I refusedthis
outlandishpayment! Ileftandcame back the nextday. The price wentup! Leaving,Icomplainedto
a Guatemalanwhowas nota governmentemployee. He pointedtothe officesacrossthe street
fromCustomsand suggestedIgoto themand ask forhelp. I did. A neatman there tookmy receipt,
walkedtoCustoms,andcame backin a few minuteswithmypackage. He saidthe cost was $1.50.
There isa cost to doingbusinessinGuatemala!
Some of the historyIlearned while workingwiththe 20+highlandelementaryschools Ihelped for
twoyears alsosurprisedme. Thingshadnotalwaysbeenthe waytheywere inGuatemala. In1951,
JacoboArbenzhad beenelectedPresident. He decidedthat,since the majorityof the population
were farmers,theywouldprobablybe more productive if theyhadenoughlandtofarm. Ninety
percent(90%) of the farmersownednoland. So PresidentArbenz lookedatthe landinthe country,
whatwas beingused, andwhatwas notbeingfarmed. He lookedatwhat part wasarable and what
part not. He lookedat whatthe landownersdeclaredtheirlandtobe worthwhentheypaidtaxes.
JacoboArbenzproposedagrarianreformlaws,“Decree 900,” that the Congresspassed.
The newlawrequiredthatlarge landownerswhowere notusingarable landsell theirlandbackto
the governmentatthe valuestheyhaddeclaredthe landtobe worth. The largestlandownerin
Guatemala,owning42%of all landinGuatemala,wasthe UnitedStatesof AmericaUnitedFruit
Company,a companythat grewand exportedtothe USA bananas. The UnitedFruitCompany
owneda lotof land itwas notusing. Accordingto the new Guatemalanlaw,itwouldhave tosell
much of that landto the GuatemalanGovernmentforre-distributiontopoorfarmersata
ridiculouslylowprice,the price the UnitedFruitCompanyhaddeclaredtothe Governmentthe land
to be worth! Thiswas highwayrobbery! Nopoor,Third-world,developingcountrygovernment
shouldbe allowedtogetawaywithsuchtreatmentof an Americancompany! The UnitedFruit
Company complainedtoitsNewYorklaw firm, SullivanandCromwell. JohnFosterDulles,the
Secretaryof State,had beena partnerinthe law firm. AllenDulles,hisbrotherandDirectorof the
CIA,had beenaBoard memberof the UnitedFruitCompany. The CIA launched acovertcampaignto
traina “liberation”armyinNicaraguatooverthrow the governmentandsuppliedAmericanpilots,
aircraft andarmamentsto provide airsupport. The CIA coup was code named“PBSUCCESS.” When

12. the GuatemalanPresident,Arbenz,appealed tohisAmerican“allies”forsupportagainstand
invadingforce in1954, imagine hissurprise thatthe USA supportwas notveryeffective!
Orderwas re-institutedtothe “bananarepublic”of Guatemalaandthe CIA-supported andpaid coup
leader, CastilloArmas,became President. He retractedthe agrarianreform. He arresteda few
thousandopponents. He investigated70,000 Guatemalansas Communists. Many“disappeared.”
Democracywas ensured!
Sittinginmyrural village,talkingwithlocal farmers,workingwithyouthsandschool teachers,Iwas
rockedby whatI learned,heard,andobserved. Iconcludedthatmyeducationhadsome gaps init
and there were many thingsIdidnot understandaboutthe worldandhow it operated. Ibecame
depressed. Ihad no ideawhere toturn. I studiedalot more,thoughta lotmore,and re-thought
whatI “knew.”
Returningtothe USA aftertwo yearsof work and shock,I continuedmygraduate education,butI
was depressedbythingsbeyondmyunderstanding. Mywife,who hadbeenaVolunteerwithme,
apparentlydecidedshe wasfedupwithmynot fittingbackintoAmerica,soshe divorcedme. That
gave me a lotmore drive to understandthese international relations,intercultural relations,power
relationship,andinterpersonalrelations. Idefinitelydidnotfullygrasp them!

13. Grandmothers Lead
I woke witha fever.Itwastoo hotand too humidtostay home,andI was worriedaboutmy
program,so I wentto work.At noon,Iwas seatedon a bamboobenchthat alsoservedas a table,
plantedinthe ground,surroundedbyanother30 benches.Aroundthe bencheswasalow bamboo
fence,highenoughtokeeppeople fromcrossingover.Atthe cornersof the enclosure,there were
tall bamboopoles,fromwhichwassuspendedathatch roof that covered the compound.Aroundme
were seatedabout500 Khmerwomenandchildren,all malnourished,mostsick,manyfeverishlike
me,manywithdiarrhea,andotherwithinfectionsrangingfrom malariatodengue and leprosyto
tuberculosis,and,of course,manywithcolds.The mothershadbowlsfull of rice andhottoppings.
Theywere tryingto getthe youngchildrentoeat the food,butthe hundreddegree temperature and
highhumiditymade itsothe childrenhadno appetite.Manyof the childrenwere beingsickoverthe
bencheswiththeirdiarrhea,coughing,sneezing,andwheezing.Flieswere enteringthe compound,
landingonthe contamination,flyingtothe food,andotherwise botheringeveryone.
The year was1983 andI was on the Thai-Cambodianborderwithhundredsof thousandsof
refugees.
Whenthe mothersfinallygave uponfeedingtheirchildren,theywouldtake theirchildrenandtheir
bowlsof foodto the exitgate.My staff made them throw the foodawayin a bucket.We didnot
wantthemtakingthe foodhome andgivingitto theirhusbandsorotherchildren.Sittingthere,too
weakto move because of myfever,justlookingatwhatwas happening;Iaskedmyself,“Are we
makingthemhealthierorspreadingdisease?”
From the survey Ihad done a couple of monthsearlier,Iknew one insix of the childrenwere
malnourished,eithermoderatelyorseverely.Isuspectedthe programwasnotmaking thingsbetter.
It gave me pause.
I wenthome andbeganworkingona proposal tochange the program.I had done a nutritionstatus
surveywithsome questionsaboutnutritionpractices.IhadinterviewedKhmertraditional doctors
and traditional birthattendantstofindoutwhattheythoughtneededtobe done.Ihadconsulted
withthe othernutritionistsinthe area,andwe haddevelopedalistof recommendedpracticesfor
mothers.Also,Ipreviouslyhad reviewedthe bestpublichealthprogramsinthe world.Ihad been
particularlyimpressedbythe Aroles’project inJamkhed inMaharashtrastate,India.Theyhad
selectedprimaryhealthcare workersfromoldervillagewomen,trainedthemone dayeveryweek,
and supportedtheirdeliveringservicestohundredsof villages.The womenwere mature mothers
whohad raisedtheirfamilies andwere respectedby otherwomen.Thatprojecthadreducedinfant
mortalityfromover120 per thousandtolessthan60 perthousandina couple of years’time.

14. Usingthe informationfromall of mysurveys,mystudiesof the bestprojectsinthe world,andmy
observationsfromthe feedingcenters,Iwrote aproposal to redesignthe supplementaryfeeding
program.I proposedselectingrespected,middle-agedmothersfromthe Cambodianpopulation,
trainingthemtodelivernon-formal adulteducationsessionstothe pregnant,lactatingwomenand
mothersof youngmalnourishedchildreninthe population.Iproposedprovidingthemwithfresh
vegetables,driedfish,andsupplemental rice andoil once everyweekaftertheyreceivedtheirclass.
I proposedweighingtheirchildreneveryweekandlettingthe mothersknow whethertheirchildren
were gainingorlosingweight.Isuggestedteachingthe womeninsmall groupsof 8 to 12 women,in
quiet,pleasantenvironments.Myprogramwouldhire a non-formal adulteducationlessondesign
specialisttodevelopfun,applied,lessonsandskitstaughtprimarilywithfood,cookingpots,
pictures,andpractice sessions.We woulddothe programas a pilot forsix months amonga camp of
30,000 people.
The UnitedNationsquicklyacceptedthe proposal. Constructionof small bamboohutswithno
external walls,slantedthatchroofsandraisedbamboofloorsthatwouldallow aircirculation
throughoutwasbegunimmediately.The hutswere builtsome distance apartsothe womenwould
onlyheartheirteachers. The hutswere about12’ x 12’. Also,new distributioncentershadtobe built
for the supplementaryfood.Once againthe distributioncenterswere builtwiththatchroofsand
bamboolanesforthe womento walkthroughandreach the area where the staff wouldhandthem
weighed amountof highlynutritiousvegetableslike collardgreensandpumpkin,driedfish,rice and
otherfoodstuffs.The womenwere givenabout50% more foodthantheyneededfortheirchildren
and themselvestoallowforspillage toothermembersof the family.Whilethe womenwalked
throughthe lines,mystaff wouldweightheirchildrenandmarktheirchildren’sweightgainonthe
children'sgrowthcardsthat the motherskept.The staff wouldalsorecordthe weights forour
record.
I hiredSheila(Englishnickname) asthe lessonplanner. She hadworkedwithmywife inPhanat
Nikkhom’sEnglishasa SecondLanguage program. My wife toldme Sheilawascreative,effective,
and self-reliant. SheilaquicklymovedtoAranyaprathet,Thailand,on the Cambodianborder,
selectedCambodianartistsandtranslators,andquicklybegantodeveloplessonplansforhealthand
nutritionlessonsforthe women. Mondays,she wouldtrainthe womenshe andthe restof the staff
had selectedtobe the teachers, andthe restof the weekshe wouldcontinuetodeveloplessonsand
artworkfor the nextlessonandobserve herteachers. Sheilawasslight,self-confident,andhard
working. She progressedrapidlyintrainingthe teachersanddevelopingthe lessons.
Cathy,a Brit witha Frenchmother,supervisedthe overall supplementaryfeedingprogram. She
quicklyabsorbedthe planandorganizedherThai andCambodian-Thai staff tocarry itout. Even
thoughshe was onlya fewyearsoutof university,Cathywasself-assuredandeffectiveinher
management,orientation,anddelegationtostaff.

15. Under the twoof them,there were the KhmerGrandmothereducators,distributioncenterworkers,
and weighingstaff. Everyone quicklygotthe ideaandorganizedtocarry itout.
Soon,TuesdaythroughSaturday,three timesaday,hundredsof womenwere studyingnutritionand
healthpracticeswiththese Grandmothereducators,receivingtheircouponstopickupfood,going
throughthe linesandgettingtheirchildrenweighedandhearingwhattheirgrowthwas,pickingup
theirfoodsupplies,andgoinghome andtakingcare of theirfamilies.
Afterabouttwomonths,the UN cancelledthe pilotprogram. Theytoldme malnutritionwasless
than one ina hundred. The linesinfrontof the primarycare centershaddwindledtoverylittle.
Hospital bedoccupancyhad gone waydown. It was sillycontinuingthe programasa pilotwhenit
clearlyshouldbe the standardforall 200,000+ displacedpeople alongthe border. The pilotprogram
was changedtothe normal program.
The concept hadbeensimple. Provide the primarycare givers,children’smothers,withthe supplies
and informationtheyneededfromcredible sourceswhoknew theirworld (grandmothers),give
feedbackopportunelyonthe children’sgrowth,andthe motherswouldtake care of the
malnutritionandill healthproblems. Theydid,resoundingly.

16. When Blocked, Improvise
Soon,my organizationwasgivenresponsibilityforthe supplementaryfeedingprogramfor200,000
KhmerSerei alongthe CambodianBorder. We extendedthe same nutritionprogramtoall of them.
Then,over50,000 KhmerRouge fledthe Vietnameseandwere settledtothe southof
Aranyaprathet,Thailand. Iwas offeredadditionalvehiclesandstaff if Iwouldprovide servicesto
them,also;however,Iwastoldthat we couldnotprovide the intensive once aweekeducationfor
the KhmerRouge. We couldonlydistribute supplementaryfood.
I didnot like thisdeal. Iwasnowthe office manager,soIwentto my UN counterpartand
negotiated. Whatcouldwe do? Just distribute the food. How aboutif we builta performance
platformwitha microphone andspeakersystemandhiredlocal performerstodothe nutrition
educationbyperformingdramawhile the motherspickedupfoodforthemselvesandtheirchildren?
Well,sure,thatwouldbe fine.
These were majorrestrictions. Iwentto Cathyand askedherfor hermost competent,self-reliant,
Khmer-speakingstaff. She suggestedLa-OngTokmohandseveral of herotherThai staff. I spoke
withLa-Ong,explainingthe charge (thankfully,she isfluentinEnglish!) anddiscussinghow she
mightproceed. Soon,she andthree otherstaff were travelingdailytothe new KhmerRouge camp,
supervisingthe constructionof adistributioncenteranda drama stage,andrecruitingtraditional
Khmeractors. She gave themthe nutritionandhealthmessagesandtheybegandevelopingtheir
skits.
Soon,whenItraveledtothe camp, I foundsupplementaryfoodbeingdistributedtomotherslike in
the othercamps and actors performingdramasduringthe distribution. One thingthatwasdifferent
here,however,wasthatnotonlythe motherspaidattentiontothe dramas,but sodid the menand
the children. Life inthe campwas boringand drabexceptforwhere ourperformanceswere
occurring.
One of mystaff,TimSchaffter,a Canadianwhowentonto become a UNICEFcountry director,did
an evaluationof the learning,practice change,andnutritionstatusof the displacedpeople inthe
differentcamps. He foundno significantdifferencesbetweenthe camps. All of the populations
were significantlybetternourishedthanbefore.
In these efforts,Iwasblessedbyanenormouslycreative,self-reliantstaff whoonlyneeded
someone togetapproval andfundingfora differentmethodology. Theydidthe rest.

17. Find What Works and Promote It
One year,while workingasthe AsianAdvisorinPrimaryHealthCare andNutritionformy
organization,ItraveledtoBangladeshtofamiliarize myself withhealth projectsthere. Isaw a
number,all quite impressive. One however,taughtme lessonsIhadnotimagined.
The projectwas calledthe “Women’sHealthEducationProject”andwasfinancedbythe
Governmentof Canada. It workedwithwomenwhohadbeenhired toworkonroad maintenance
and receivedenoughfoodforthemandtheirfamilytolive asthe paymentfortheirlabor. The
womenwere indigentwomenwithoutsourcesof income orproductionwhohadbeenwidowedor
divorcedandwhohad childrentosupport. The road maintenance project,providingfoodforwork,
was a wayto keepthemalive.
An innovativestaff person,ayoungnurse,haddesignedanotherprojectforthem. She hadlooked
for healthandnutritionrelatedindigenouspracticesthatwere beneficial tofamilys’health. She
identifiedquite afewanddevelopedlessonstoteachthemto these roadworkers. The lessonswere
organizedinanintriguinglydifferentway. Theybeganbyexplainingwhatthe proposedpractice
was. Thenthe practice was demonstrated. Thenthe womenlearnedhow tocorrectlydowhatwas
beingtaught,learningthe stepsandpracticingit. Theythenwentintothe village andfound
someone whoneededthe treatmentandappliedthe treatmenttothem. Thentheywenthome and
wentabouttheirbusiness. The nextweek,before theirnextlesson,theyfoundthe personwhohad
beentreatedandfollowedupwhathadbeentreatedanddecidedhow effective the treatmentwas
and whethertheywantedtouse itinthe future. For those who did,theyreviewedthe stepsand
proceduresagain,tosolidifythe practice intheirminds.
The projectreportedan astonishing rate of learningthe informationandadoptionof the practices.
The end of course achievementof learningobjectivesamong12,000 womenwas97%. Six month
follow-uponlyindicateda5%decline inlearning.
Thisprojectbecame mynewstandardfor effectivedesignandachievablebehaviorchange.

18. Water is Life
In 1989, I transferredfromBangkok,Thailand,toLa Paz,Bolivia. Some of youmay know La Paz as
the two anda quartermile highcapitol. Ilearnedquite afew lessonsthere,especiallyaboutwater,
sanitation,andhygiene andthe importance of the firsttorural people.
In Bolivia, Iwasamazedbymany things. Regardinghealth,whatsurprisedme the mostwasthat
rural people keptsaying“Waterislife.” Once,Ihad mystaff interview hundredsof villagerstofind
whattheymost wanted,assumingwe couldworkwiththemtoobtainanything,whichof course was
not true. The toptwo responseswere water. Householdwaterandirrigationwater. Thathadnever
occurredto me.
Since then,talkingwithvillagers,Ihave foundsome whowalkedhourseachweektodraw,load,and
carry water home. One frienddidasurveyfor the Ministryof Educationto findwhyyounggirls
were withdrawnfromschool. The determiningfactorwaswhetherthe familyhadwaternearto
themor not. If theydidnot, the younggirlswere takenoutof school to carry waterto the home or
to herdthe family’slivestocktothe watersource andback. I was amazed. It neveroccurredtome
that the maindeterminanttoyoungwomenbecomingbettermothers(highlycorrelatedwith
educational level of the mother,accordingtoUNICEF) wasproximityof awatersupply.
In Bolivia,Iwasgivenawater,sanitation,hygiene,immunization,andnutritionprojecttomanage in
200 villagesinfiveRegionsof Bolivia,averylarge territorial dispersion. Ittookover24 hoursof
drivingfromLa Paz to reachthe most distantvillage. The projectwasenteringitsfourthandlast
yearof funding. Ithad achievedabout25% of itsobjectives,tothe extentwe knew. Myjobwasto
make sure the projectwas successful.
Most of the watersuppliesthe projectbuiltwere gravityflow,spring-fedwatersystemswithtanks
above the village andapipednetworkthatsuppliedeveryhousehold. The latrineswe builtwereall
odorless,eitherVIP(ventilatedimprovedpit) orpour-flush. We were committedtotrainthe
villagerstomaintaintheirwatersuppliesbyorganizingwatercommittees,havingtrainedplumbers,
and collectingwaterfees. There wasevenaninitial monetarycontributionthe villagerspaidin
additiontolaborand local materialsforthe system.
The firstthingI didwas to organize andconduct a rapidfieldsurveyof whatpeople’sknowledge,
attitude andpracticeswere vis-à-visthe projectgoals usingasubsetof questionsfromthe Bolivian
DemographicandHealthSurvey(DHS). Imade interview formsthatusedthese testedquestionsand
answersandsentthemto my fieldstaff tocollectthe data,explainingthe samplingmethodthatI
wantedthemtouse,a systematicsample. Theyreturnedthe surveysandwe enteredandanalyzed
them. The situationlookedpretty badforbeingable toachieve ourgoals.

19. I consultedmystaff howtheythoughtwe couldachieve the goals. Theylistedalitanyof problems
and obstaclesthatpreventedthemfromgettingsuppliesandfundsfrommyoffice. ItoldthemI
wantedthemtoget the workdone,to go all out,and that I wouldmake sure the fundingand
materialsgotto them.
My jobfora yearwas to remove the bureaucracyandfuel the work. Our agreementwasclear. They
were togo all out. I was to ensure theyhadthe fundsandthe materialsIcontrolledopportunely. I
traveledtothe fieldoften,workingasacheer-leaderandproblem-solver. The staff workedlongand
hard witha lotof dedicationandcreativity.
Withina year,90% of the projectgoalshad beenmet,upfrom 25%. The donors,includingthe U.S.
AgencyforInternational Development,wereverypositiveandgave usa no-costextension. Withina
fewmore months,the projectwascompleted.
The baseline DemographicandHealthSurveyDataforBoliviaindicated that,invillageswiththe
profile of those inmyproject,33% of the under-five yearoldchildrenhaddiarrheawithinthe last
twoweeksat the start of the project. Atthe end,we measuredadiarrheal disease prevalence rate
of 7.5%, overan 80% reduction. We didnot try to measure the mortalityrate. The immunization
rate inour villageswentover80%of undertwoyear oldswithall immunizationscompletedbyone
yearof age,enoughto produce whatiscalled“herdimmunity.”
The lessonsfromthisexperience seemedtobe atleastthree. One wascollectessential datathat
letsmanagersandbeneficiariesknow whatthe statusof coverage was. The conceptisthat you
can’t improve somethingunlessyou trackit. The otherwasfor managementtofacilitate the flow of
essential suppliesandfinancestothe frontline workers,nottoblockthem. Youmightcall itstoking
the boilerratherthanstarvingit. Anotherwasto respondtofeltneedsof the people inwaysthat
meetandsurpassthe population’sexpectationsandconcomitantlymeetspotential health,time-
saving,sustainability,andaffordabilitypossibilities. Concisely,respectanyof the population’stop
prioritiespossible andjoinexternal informationandresourcestothose of the population,usingas
much of the local knowledge,practices,anddrive thatare conducive tocommongoal achievement.

20. Ecuador: Seize the Opportunities and Respond to Felt Needs
In 1991, I was transferredtoEcuador fromBolivia,travelingthroughLima. Cholerahadjustreturned
to thishemisphereforthe firsttime ina century. Talkingtoa taxi driverinLima,I was surprisedthat
he wantedinformationabouthowtopreventcholera. Essentially,he wasaskingme forbasicwater,
sanitation,hygiene,andoral rehydrationtechnologies. Isharedthe mostapplicable of the
informationandtechnologiesIknew.
In Ecuador,I was to be managerof a rural medical doctortrainingprojectthathad half a dozenstaff
inthree provinces. Shortlyaftermyarrival,the senior staff tookme tothe fieldtoobserve whatthe
projectdidand see some of itssuccesses.
From Quito,we drove toLos Riosand Bolivarprovincesandvisitedvillageswhere doctorsthe staff
workedwithwere givinghealthlecturestothe villagers. Afterthe lectures,Iaskedthe villagershow
useful the lectureswere. Theyrepliedthatthe lecturesweregreat,buttheywantedtoknow what
to do aboutcholera. I askedwhattheirbiggestconcernwas. Cholera. Whatdid theyneedto
know? How to preventandsurvive cholera. Iaskedthe questionsimpartiallyinvillage aftervillage.
The villagerswantedtoknowwhattodo about cholera,butdoctorswe workedwithwere teaching
whatto do about otherproblemsandnotcholera.
Aftera couple of daysof this,I ledmystaff througha SWOT exercise examiningourcurrent
situation. SWOTisa businesstechniqueof lookingatstrengths,weaknesses,opportunities,and
threatsto decide whattodo. Theyconcludedthatwe neededtouse ourstrengthsto redressthe
problemof cholera. Iaskedwhat theywoulddoandhow theywoulddoit. I askedwhat strengths
and opportunitieswe had. IcombinedwhattheyrecommendedwithwhatIknew andhad
concludedfromBoliviaandSoutheastAsia. IfurtheraddedwhatI knew fromRichardG. Feacham’s
recent(at thattime) reviewsof waterandsanitationforthe WorldHealthOrganization.
Arrivingbackat my office inQuito,Idesignedaprojectanda budgetforan ambitiousconceptpaper
to overcome cholerainLosRios,one of the more affectedprovinces. Forthe projectdesign,I
consideredwhatthe villagers hadsaid,whatmystaff had concludedandadvised,andwhatthe
literature indicatedwere the bestapproaches. Todevelopthe budget,Iusedax Excel spreadsheet
withthe travel,staff,andmaterialscostsIwas told. I wrote itup in a 13 page concept paper. I
requestedthatthe staff arrange a meetingwiththe USAIDhealthprogrammanagerinEcuador, Dr.
KenYamashita.
Dr. Yamashitametus. We talkeda while,gettingtoknow eachother. I toldhimwhatI had
experiencedtravelingthroughLosRios andBolivar. ThenI presentedhimthe conceptpaper. He
was shocked,asking,“Whatisthis? Anunsolicitedprojectproposal?” Ireplied,yesitwas. I

21. explainedthe need,the interventions,the goals,the budget,andthe time frame. He saidhe did
have some unspentendof the yearmoneyandhe wouldgetbackto me.
A monthlater,I receivedacall,requestingIrevise the budgettowhatUSAID/healthwouldhave left
overat the endof the fiscal year. My initial proposal hadbeentoeliminatecholera transmissionin
everyprovince myagencyserved. Idesignedbackfora $650,000 budget,reducingthe coverage
appropriatelyto30,000 families. Ire-submittedthe proposal,fleshingoutthe methodology.
Specifically,Iproposedto onlyentercommunitiesinwhicheveryfamilyinthe community
committedtosanitation,hygiene,andoral rehydrationactivities. Further,ratherthanselectingthe
communities,withinhighdisease incidence areas,Iproposedthatwe offertocollaborate withevery
communitythat1) wrote a letteraskingforour help,2) dida communitysurveyof all families,and
3) got signaturesof intentiontobuildlatrinesfromeveryheadof household. We wouldadvertise
the possibilityof receivingourcollaborationoverthe radio,then respondedtothe communitiesthat
contactedus.
USAID agreedtofundthe proposal. The agencydirectorandI got a meetingwiththe Ecuadoran
Ministerof Health,Dr. Naranjo,andwentto meethim, expectinghisapproval. Instead,Dr.Naranjo
toldus that he wantedthe projectre-designedtoprovide spottycoverage ineveryprovince of
Ecuador. My directortentativelyagreed. Iwasappalled,figuringthisapproachwoulddestroythe
effectivenessandthe manageabilityof the program. I calledthe USAIDassistantdirectorwithwhom
I had workedinBoliviaandexplainedthe situation. He metwiththe Ministerandreacheda
compromise position: we wouldworkinthree provinceswherecholerahadahighincidence and
where myagencyalreadyhadstaff and workexperience. The Ministeragreed.
My nextchallengewasthatI wasnewto Ecuador and had nocredibilitywiththe agencystaff. To
overcome this,Irequestedthe agencytrainertoworkwithourmost experiencedwater,sanitation,
and hygiene promotionstaff todevelopatrainingplanfornew staff. The task wasfor the
experiencedstaff toworkouta trainingandskillsdevelopmentplanfornew staff we hadto hire to
carry out the program. Theywere supposedtoplanhow to make new staff as competentasthey
were ina two weekintensivetrainingplan. We sentthe mostexperiencedstaff fromthe various
waterand sanitationprojectswe hadinthe countryto go intoa comfortable site inone of the
choleraoutbreakareasof Los Rios. Theircharge was to developandwrite atrainingplaninthree
weekstime. The impactandcoverage goalswere those Ihad proposedtoUSAID. The budgetwas
whatI had proposed. The trainingplanwastheirs,withone caveat: I requiredthatnew staff goto
the villagesandconsultthe villagersbythe afternoonof the firstdayof trainingandthat approaches
be modifiedonthe basisof whatthe villagerstoldthemandwanted. The staff andtrainer
developedawrittentrainingplan. The advantage of doingitthiswaywasthat it got mymost senior,
highstatusstaff investedinthe project: theywouldmake itsucceedbecause itwastheirbaby,too,
now.

22. The latrine designswe woulduse werethe WorldBank’stestedandprovenVIP(ventilatedimproved
pit) and pour-flushlatrines. Whatwe usedwoulddependonthe watertable andthe villagers’
preferences. These were odor-free,fly-freelatrines thatcouldbe usedwithprivacy. The advantage
of odor-free latrineswasthatbad-smell wasthoughtbylesseducatedpeopletocause disease. The
fly-freedesign,onthe otherhand,preventedfecal transmissionbyflies. Combinedwithhand-
washingwithsoapafterlatrine use andbefore meal preparationand/orconsumptionand
appropriate watertreatment,theseserviceswoulddecreasecholeratransmissionaswell asthe
otherdiarrheal diseasesthatregularlykilledinfantsandyoungchildren. Cholera,killingadults,
frightenedthe populationbecause theyfeltchilddeathfromdiarrheawasnormal butthe deathof
adultswasnot. Whenadultsstarteddying,somethinghadtobe done. Theywere readytoact and
act fast!
Our approach,however,wouldnotonlydecreasethe transmissionof cholerabutof the diarrheal
diseasesthatraisedthe childmortalityrate andcausedmiseryandsufferingamongmothersand
fathers.
A numberof taskshad to be completedquicklyandefficiently. One wasrecruitingandscreening
competent,motivatedstaff. Anotherwaspurchasingmaterials. Anotherwasarrangingfora
trainingsite andcompletingthe preparationfortraining. Also,we neededtokeepourcounterparts
and the villagersinformedsothatwe couldgetthe workdone fast andefficiently. Finally,we
neededtoconducta baseline surveyandhave planstoevaluate afinal against it. All the staff hadto
workfast and efficiently,preparingforthe work. Theydid.