First, the Economist on the role ‘amateur’ health care workers can play in building public health systems:
The idea is to harness people’s existing culture of self-help and get subsistence farmers to carry out simple medical tasks which are beyond the capacity of a pathetically inadequate health system…
In Congo alone, the [World Health Organisation] has recruited more than 35,000 community workers for its river-blindness project; they get nothing for their labours except the knowledge that they are protecting their families from disease.
Volunteers from each village are taught how to measure out the annual drug doses, fill in the obligatory record forms, and watch out for side-effects. WHO supplies the drugs and the villagers do the rest themselves. WHO was forced to devise the strategy after it received an offer from Merck, a pharmaceutical firm, of free supplies of a drug to people at risk of river blindness.
Second, a report [pdf] from the Mercatus Center at George Mason University that tells the story of why one community in New Orleans East was able to make a rapid recovery, despite returning to an area officials recommended should be abandoned:
Following the devastation of the 2005 hurricane season, it was unclear whether many of the affected communities would rebound. But within weeks of the storm, the neighborhood surrounding the Mary Queen of Vietnam Catholic Church was showing clear signs of recovery, setting a pace that would continue until almost all the residents and businesses had returned by the summer of 2007… This community was able to make use of an array of cultural tools that aided their swift return. In particular, historical narratives common to members of this community and the appropriation of the “model minority” myth served as effective tools in the rebuilding process.
Third, the story of Doris Voitier, a New Orleans school superintendent, and her battle to reopen the schools in her parish:
Voitier became something of a local hero when she realized that functional schools were critical to getting residents to move back to the parish. She decided she’d figure out a way to open them, bureaucracy be damned.
Enter FEMA. FEMA officials told Voitier she’d need to have a “kickoff meeting” before she could open the schools-where she’d meet not with parents, or students, or teachers, but with a federal environmental protection team, a historical preservation team, and the “404-” and “406-mitigation teams” (terms which refer to specific sections of the Stafford Act, the law that covers federal disaster response). And it wasn’t a “meeting” so much as an introduction to the vast bureaucracy that was FEMA’s “education task force,” basically a list of barriers Voitier would have to clear before she could start classes. Voitier says she sat in the meeting thinking, “Can’t somebody help me get a school started and clean my schools?”
Voitier decided to cut her losses and reopen the schools without FEMA’s help. She says she adopted a “the heck with you guys” approach. “We can do it, we’ll make it happen, and we’ll send you the bill.” Before Thanksgiving, Voitier opened her first school, and 334 students attended the first day of classes. By the last day of the year, there were 2,360, and over 3,000 on the first day of the next.
I am sure you know where this story is heading: “For her heroic efforts to reopen her schools, Voitier would later be investigated for misappropriation of federal property.”
Finally, and in a similar vein, the story of Ada Dolch (pdf), the principal of a high school in the shadow of the World Trade Center. Dolck evacuated her students just ten minutes before the first tower fell:
I saw from my window that there were literally things flying out of the Tower. I immediately thought that the debris could fall on our building and the resulting worse case scenario would be a fire. This building is 14 stories high and it has narrow halls and stairways. It would take time to evacuate so I thought the sooner we got started the safer it would be.
I called HQ once and they questioned my decision to evacuate. But that was the last time I used the phone. I decided that I can’t spare the time to wait for decisions, I couldn’t afford the distraction.
Under extreme pressure, Dolch, whose sister died that day in the WTC, obeyed her instincts – but her reactions were grounded in planning and rehearsal (“when you are the responsible one… you plan, review, practice and go back and fix the problems.”).
Each year, she had bought two or three walkie talkies (at $900 a pop) with money squeezed out of her budget, allowing her to communicate effectively with other teachers and to listen in to police transmissions. And she had made sure that every member of her staff was ready to spring into action:
There is a secret statement in this school – which I will not share with you. However, periodically I ask my staff when I am in meetings – what do you do, what are your responsibilities if that secret statement comes over the walkie-talkie? I don’t ask them if they know that statement – I assume that they do. I want to know that they know what to do when I make the statement.