Assignment: Innovation is fostered by Information
Assignment: Innovation is fostered by Information
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M argaret J. Wheatley once stated,”Innovation is fostered by itiforma- tion gathered from new connections; from insights gained by journeys into other dis- ciplines or places; from active, collégial networks and fluid, open boundaries.” When I presented my credentials to South African President Thabo Mbeki on Aug. 15, 2006, as the newly appointed ambassa- dor to one ofthe largest U.S. embassies in the world, I began one such journey that would test the boundaries of my creativity in the face of considerable obstacles.Assignment: Innovation is fostered by Information
Having served as undersecretary for food, nutrition and consumer services at the U.S. Department of Agriculture, and as commissioner and chief executive offi- cer of the Texas Department of Human Services, I was no stranger to the com- plex challenges inherent in the field of human services. Within these contexts, I had worked successfully to provide for the health and nutrition of women, children and families across the United States and abroad through initiatives such as the Food Stamp Program, the Special Supplemental Nutrition Program for Women, Infants and Children, the National School Lunch and School Breakfast Programs, and the Commodity Distribution Programs. The role of ambassador, however, would require me to manage the full range of the U.S. government’s programs across 26 agencies, all within an international environment.
The largest and most successful public human service project I directed as ambas- sador was the President’s Emergency Plan for AIDS Relief, or PEPFAR. During my tenure in South Africa, this program successfully expanded to provide antiret- roviral treatment for more than 375,000 South Africans and to supply Prevention of Mother-to-Child Transmission services for over 1.5 million South African women suffering from HIV/AIDS. It is important to note, however, that this success did not come without significant challenges. After all. South Africa has the highest rate of HIV/AIDS infection, with more than 5.3 million people infected, and 1,000 fatali- ties per day. As a result of this high mortal-
the field worksc- ity rate, there are more than 1.5 million child-headed households in the country.
While the scope of this crisis alone presented a tremendous challenge, formulating a plan to address this cri- sis was further complicated by several systemic impediments, such as a lack of infrastructure and technical expertise. Although South Africa is the wealthi- est nation on the continent, more than 51 percent of its population still lives on the equivalent of less than US $1 per day. This harsh socioeconomic situation
By Eric Bost
conventional boundaries and outside the established human service infrastructure to meet the needs of people in their own communities. One story in particular illus- trates this process perfectly. When seeking to increase the recipients of PEPFAR ser- vices, the embassy identified two groups of people unlikely to seek testing or treat- ment from PEPFAR clinics. One group comprised those individuals who did not want to know their HIV/AIDS status. The other group was made up of those who did not feel comfortable visiting established
Innovative Human Service Lessons For-and Learned From-South Africa has driven many of the country’s most educated citizens to seek jobs overseas. As a result, many worthy programs that do receive funding lack the professional staff to operate effectively. Furthermore, while 14 years have passed since the end of apartheid, many systems for the pro- vision of services have yet to be modern- ized to meet the needs of the nation.
Finally, to all of these challenges must be added the fact that the U.S. govern- ment, no matter how well-intentioned, is addressing the HIV/AIDS crisis in Africa as an outsider. It was my task, as ambassador to convince the South African government and PEPFAR’s 500 partners that the United States intended to approach the issue with an attitude of true partnership and collaboration. Over time, and with repeated efforts to reach out to government officials, I was able to overcome initial concerns about U.S. intentions to forge a relation- ship characterized by a high degree of teamwork.
In spite of these obstacles, or perhaps because of them, we were able to craft effective solutions to extend much- needed treatment to previously under- served populations of South Africans with HIV/AIDS. I am convinced that the challenges we faced in South Africa forced us to innovate — to go beyond
PEPFAR clinics. Further study of this sec- ond group revealed that they would prefer to consult traditional healers within their own tribes or villages. While we could have launched a public information campaign to attempt to persuade these individuals to visit PEPFAR clinics, we decided to deal with this issue from a different perspective. Ultimately, we were able to obtain PEPFAR funding and training to allow traditional healers to counsel their patients on HfV/ AIDS prevention, testing and treatment options, helping us to serve more people.
Moving forward, I am able to carry with me into new challenges those practices that I saw proven in South Africa: striving to better understand those we serve and developing creative ways to reach out to them within those contexts where they feel at home. As the newly appointed vice president for global initiatives at Texas A&M University, I look forward to develop- ing equally innovative programs that will continue to move the university forward into the international arena while respect- ing those traditions it holds dear. SI
Eric Bost served as the U.S. ambassador to South Africa from Aug. 15, 2006, to Jan. 20, 2009. He is now vice president of international studies atTexas A&M University. He served on the Board of Directors at APHSA.
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