Gen Y and global health: Not a match made in heaven

What would you think if a job that you were interested in asked you to work for free for at least six months to a year before even considering applying? And not only work for free, but also work abroad? Would you jump at the opportunity?

This is a basic expectation of most entry level jobs in global health and the entry level jobs that expensive to obtain experience qualifies you for are far from challenging and substantive. Here is an excerpt of responsibilities from a large nonprofit organization that works in global health (portions are redacted that are specific to the organization.)

“• Assist in preparation, review, and editing of reports, scopes of work, papers, manuals and presentations;
• Schedule and coordinate meetings and prepare necessary meeting materials;
• Maintain organization of electronic and paper files;
• Assist with tracking and submission of all project deliverables on two key projects;
• Work with travel agent to coordinate travel logistics for site visits and meetings;
• Assist in preparation of consulting agreements, purchase orders, and/or sub-contracts.” 

Global health is definitely one industry where Gen Y has not changed the way the workplace functions. There is a high barrier to entry for recent college graduates who can not afford to pay for their volunteer experience abroad neither during college internships nor after graduation. Unpaid internships are the norm rather than outliers. Global health is an industry where supply outstrips demand, partly due to the advent of high profile organizations such as the Gates Foundations and the Clinton Foundation.

Even when you finally enter the workplace, finding a challenging position is very much about paying dues. Entry level jobs consist almost entirely of administrative work. Management hierarchy and approaches to management are heavily influence by government practices due to the overlap of both personnel and the funding from agencies such as United States Agency for International Development (USAID). These same management practices certainly play a role in the declining interest in government careers.

Millenials generally have two paths to receiving a promotion: work in the mindnumbingly dull entry level job for 2 years or go to graduate school. Promotion is heavily based on seniority of tenure and/or credentials rather than talent and expertise. I would love to spare myself from spending thousands of dollars, however it is not really an option. My decision to live abroad was prompted as much by personal reasons as career considerations.

The future of this field depends on the injection of new ideas and perspectives that Gen Y has to ability and desire to deliver.  I wonder when and if the powers that will be willing to accept and welcome them.

The stock market: Alternative financing for non-profits

Lucy at Philanthropy 2173 has started an interesting discussion regarding cross-platform philanthropy:

“Just as a radio program or tv show must now be developed with an eye toward its other media platforms and outlets, our public/philanthropic financing of these ventures need to be considered within these “cross sector” financing opportunities. We need to think of philanthropic funding strategies – and the public goods they support – as cross-platform. Public goods are now provided by private firms, public agencies, nonprofit organizations, and social enterprises. They are funded by public dollars, charitable donations, fees for service, corporate sponsorship, licenses, social investments, sales, and search engine/ad revenue. Oh, I like this metaphor – I’m gonna have to expand on it — next post.”

Taking the idea further, I started thinking about changes that might take place if non-profits were traded on the stock market like for-profit enterprises.

1. More secure and steady source of funding

Currently, non-profits compete for a limited set of funds among possible donors. A donor’s choice of the beneficiary may be influenced by media coverage of the cause the organization supports. Because there is a finite source of funds, prevailing priorities determine which causes and organizations gain the most. Reliance on quarterly fundraising totals can swing between feast and famine with any number of factors affecting donors: economic conditions, other pressing events, etc. Companies participating in stock exchanges generate profit from the value they offer through goods and services. Generating profit is not a zero sum game in the market; all organizations have the opportunity to show the value that their organization brings about and earn profit.

2. Changes in the organizational governance structure

Trading non-profits on the stock market also democratizes the governance structure of the organization. Shareholders have a financial stake and hopefully a personal interest in effective programming. Members of the community can share their insight about how the organization can be most effective directly with management. Involving more opinions in the direction and governance of the organization diversifies perspectives and strategic direction, much like some organizations hope to do by recruiting millennials to non-profit boards.

3. Altered definition of organizational accountability and responsibility

Non-profits would have an external measure to determine how well they are at doing good. Right now, most accountability for evaluation and demonstration of effectiveness is less of a requirement for continued donor support. Within the market, organizations that could prove they actually accomplish what they set out to accomplish will see the dividends literally in the stock dividends. Developing and maintaining effective and sustainable programs would affect the bottom line, promoting evaluation and the incorporation of best practices.

What do you think about the idea of nonprofits on the stock market? Worthless adaptation from for profit enterprises or the future of nonprofit fundraising? Let me know what you think in the comment section below.

Thoughts on race and life abroad

Living abroad challenges your cultural perceptions as much as the cultural perceptions of the people you meet. I have traveled to locations varied enough to both appear to be from the country that I was in and appear to be a foreigner. More often than not, reactions and comments, positive and otherwise, are spurred by race. In China, I was perceived as a oddity; families asked me to pose in their vacation photographs. In Brazil, people I met assumed that I was Brazilian and did not believe me when I told them otherwise. Policies may actually discriminate against certain nationalities or races.

Race remains an issue in social interactions; the concept of colorblindness is debatable. Political correctness is a cultural phenomenon that changes, depending on location as much as context. Part of being in a foreign country is learning to adjust your sensitivity to racially tinged comments.

1. Ask about what you hear.

In Argentina, it’s common to use the word negro or negra like a term of endearment. In most other contexts, the word is used to describe something or someone who is black. The first time I heard someone call me negra, I thought it was odd they were being so forward. Asking about it made sure there was no misunderstanding due to the language barrier. It also prevented from me being upset about something that is perceived as harmless.

2. Definitely ask if you are thinking about correcting a misconception.

During my first week here, I had lunch with the staff at a local drug rehabilitation center. After a nice lunch conversation, one of the women who worked there asked me if I could sing. I asked her why wanted to know. She told me that once she had heard a black woman sang and she really enjoyed it, therefore implying that because I am black, it is likely that I am a good singer as well. I made a joke about how I sing in the shower (poorly), but told her that I am sure that she enjoyed the performance because the woman was talented. Correcting misconceptions is usually not about lectures and angry reactions.

3. All else fails, consider the experience as a part of travel.

I meet new people, especially patients at the clinic, all the time while I am in La Plata. Not one person I have met has guessed that I am American even though there are several American students here. The perception is prevalent that Americans are white. Of course, there are some benefits to not appearing American, but it is also odd and vaguely frustrating to explain to people that I am not Brazilian or Dominican.

This does not mean that you have to spend time with people who insult you. There are ignorant people all over the world; feel free to ignore them just as you would ignorant people in the country you live in.

A momentary setback and a small victory

The good news:

At least some of the political momentum regarding the proposed changes to the clinic has slowed. The authorities in the municipal health department are willing to allow my supervisor to keep his job as chief of the center. They still intend to introduce other clinical specialties to the clinic, an ill-conceived proposal full of problems. It appears that we have won the first phase and are moving on to the second to try to preserve the clinic as it is now.

The bad news:

The project that I intended to complete at my job will have to be indefinitely postponed. My grant proposal got rejected, which was a surprising outcome for everyone involved. I have tried to jumpstart a creative phase to develop an alternative project that can work with the short timeline I have. I will be sure to let everyone know the final result.

Making vaccines more accessible

flickr image courtesy of phitar

While at a conference for my job last year, I saw a small anti-vaccine protest in front of the Centers of Disease Control and Prevention. The protesters were there claiming that one of the components in vaccines, mercury thimerosal, causes autism, an assertion that has not been proven in countless scientific studies. What countless studies have proven is that vaccines have saved millions of lives and prevented life-debilitating disabilities, making immunization one of the most important public health discoveries in history.

There is a need to change perception of the safety of vaccines. The very ubiquity of vaccines cause people to take for granted the absence of deadly diseases like smallpox. Rejection of recommended vaccines may explain why there has been a resurgence of preventable diseases such as measles and whooping cough.

A recent article in the New York Times discussed why false information tends to have influence even when it has been shown to be false. Source amnesia causes humans to respond to false information as though it were true despite being shown evidence that counters that false claim. Source amnesia may bear part of the blame for the existing perception that vaccines cause autism.

Overcoming this particular false perception represents a tough social marketing challenge. You have a highly vocal and motivated minority actively trying to stop a positive intervention. Fear and misinformation has taken the place of rational discussion based on scientific evidence. How do you make one perceived risk (autism) seem less dangerous and/or less likely than the actual risk (death and disability)?

For more information about vaccines, visit Voices for Vaccines.

Hat tip to Nedra for the NYT article link via Twitter.