Michael Kleinman — Sustainability is Not Just a Buzz Word
Somewhere, in a magical, mythical developing country, all aid programs are sustainable. Using participatory approaches, NGOs work with government ministries to design and implement projects which address various underlying causes of poverty, supported by donors who are committed to long-term engagement. It’s a development utopia; an aid worker Valhalla.
Reality, however, falls somewhat short. What does sustainability mean when the government lacks the capacity – or the will – to assume responsibility for service delivery? What does sustainability mean in a country like Chad, or the Congo?
There’s often a kabuki-element to coordinating with a government in a failed or failing state, the triumph of form over function. Consultations, permissions, endless coordination meetings, when everyone knows the projects will end as soon as the NGO leaves, or donor support disappears.
This is not to say that the situation is hopeless, or that the work serves no purpose. A mother doesn’t die in childbirth, a child doesn’t die of diarrhea, a girl learns to read. These are incredible things, even if the project itself isn’t sustainable in the long-term, even if the clinic or school will eventually sit empty.
Sustainability is a reasonable goal in some countries, and an empty promise in others. To that end, we need a new lexicon, a more accurate rhetoric. We need a way of describing our programs that describes – accurately describes – what we can realistically achieve, and what we can’t. It’s the least we owe to ourselves, our donors, and the people we serve.
Michael Kleinman spent a number of years working for aid agencies in Afghanistan, across east and Central Africa, and in Iraq.
Editor’s Note: Establishing a strong relationship with government can be a challenge in many sub-Saharan African countries, particularly in conflict settings. Luckily for the Touch Foundation, Tanzania has enjoyed more than a decade of political stability. For more on Tanzania’s political, economic and development situation, click here.
Emily Bell — Partnering with Government
The Who Cares? Blog will be exploring the theme of government partnerships this month.
In the developing country context, international nonprofits usually require a strong relationship with and buy-in from national and/or local government to enable positive change. The Touch Foundation is no exception. Touch benefits from a close relationship with the Tanzanian Government, meeting and collaborating regularly with their Ministry for Health and Social Welfare. Tanzanian President Jakaya M. Kikwete himself has met with Touch Foundation President Lowell Bryan on several occasions, including at the State House in Dar es Salaam this past spring.
The Touch Foundation’s goals are closely aligned with those of the Tanzanian Government. The Government is determined to improve health care and pledged in 2007 to build hundreds of new clinics and health centers to ensure that no one is more than five kilometers (three miles) from medical care. This infrastructure is essential, but without medical staff, managers, drugs, and other resources, its impact will be limited. Based on our experience at Weill Bugando’s medical college, the Tanzanian Minister for Health and Social Welfare personally asked the Touch Foundation to assist his Ministry in scaling up health worker training capacity at the national level. In early 2007, the Ministry developed the newly published Twiga Initiative to dramatically increase health worker production. With the help of McKinsey & Company, we identified a baseline for current national training capacity and developed and prioritized initiatives to help the government achieve health training goals.
The Tanzanian Government relies on support from donor country governments to carry out its policies. Coordination and communication between donor governments and the myriad of nonprofit organizations in Tanzania are also therefore of paramount importance. In many cases, nonprofits may provide valuable information about a political, health or social situation that can help inform the development policy of a donor country like the US. The United States Agency for International Development (USAID) is a key development partner for the Touch Foundation in Tanzania. They are supporting our work to strengthen the health workforce through a Global Development Alliance public-private partnership.
An exciting development has been the US President’s Emergency Program for AIDS Relief (PEPFAR)’s growing recognition of the need to train more health workers to control HIV/AIDS globally, particularly in Africa. PEPFAR has committed to supporting developing countries to train at least 140,000 new healthcare workers in HIV/AIDS prevention, treatment and care. In this podcast, Touch Foundation’s Executive Director Lee Wells shares our view on the importance of health workers in tackling the major disease killers.
This month, we welcome your thoughts or experiences relating to government and nonprofits partnerships to support positive change in global healthcare.
Emily Bell is Head of Advocacy and Communications at the Touch Foundation.
Barrick Gold and the Touch Foundation – Joining Forces to Tackle Malaria
Tory Ervin, Touch Foundation and Steve Kisakye, Barrick Gold
Tory Ervin: Forging a Public-Private Partnership for Malaria Control
I am spending the summer working as an attaché to the Touch Foundation at Barrick Gold Mining Company to assist Barrick in its malaria control program and to develop a partnership between Touch and Barrick in the Lake Zone region of northwestern Tanzania.
To give you a bit of context, Barrick Gold has 27 mines around the world, with four located in Tanzania. Barrick employs over 4,300 people in Tanzania alone. Having spent most of my working years at nonprofits and in the Peace Corps in Kenya, understanding how the mining industry operates and how it can invest in local communities through health, education and microfinance initiatives has been invaluable.
So, why malaria, you might ask? The Lake Zone, where the Barrick mines are located is mostly rural, and has some of the worst malaria rates in the country. For instance, in some parts of the Lake Zone, the prevalence rate is 39%, compared to 1.2% in Dar es Salaam. In Tanzania each year around 12 million people suffer from malaria, and over 20,000 people die from this preventable disease.
Malaria has a severe impact on the workforce at Barrick mine sites and in the communities surrounding the mines. I have been working with Barrick to strengthen their malaria control programs through their three-pronged approach:
- creating a robust indoor residual spraying program with the local and national governments;
- developing materials for malaria information and education campaigns; and
- coordinating with the government’s Catch-up Campaign to distribute bed nets to every household in Tanzania with a pregnant woman or a child under five years.
While Barrick’s aim is to build this program out with the government to all of Kahama District (covering ~800,000 people), malaria will likely remain a cause of illness and death at Bugando Medical Centre – the second largest hospital in Tanzania – until prevalence and incidence rates drop throughout the entire Lake Zone. The Touch Foundation has been working in the Lake Zone since 2004 to strengthen and support the Bugando medical school and hospital there. Currently, malaria is the leading cause of death in Bugando’s pediatric ward, and accounts for almost 24 percent of all outpatient cases. Many complications during childbirth are attributable to women who do not receive proper malaria prophylaxis (preventative) care during pregnancy and suffer from anemia before and during pregnancy.
It is frustrating to know that with increased access to education about malaria prevention, better localized diagnostic services, and an improved drug distribution system, fewer people would be dying from this treatable disease.
My experience this summer has underscored the importance of the Touch Foundation’s work to expand health worker training and strengthen health care, and the benefits of working with partners such as Barrick to increase medical access and services to people who need it. To tackle malaria, we will need all hands on deck!
Steve Kisakye: Barrick’s Take on Community Health
I came to know the Touch Foundation through my work as Barrick Gold’s Community Health Coordinator in Tanzania. My work involves many things, but at its core is the development of strategic partnerships to ensure that the workforce at all Barrick operations in Tanzania go home healthy each day and that the host communities in which we live and work have access to quality health care.
These health partnerships focus on:
- combating HIV/AIDS and malaria,
- increasing the capacity of local health centers,
- facilitating the provision of dental services,
- training peer health educators in the community,
- facilitating access to surgery for rural residents,
- establishing access to secure water supplies.
We are doing the majority of this through our newly established Lake Zone Health Initiative, one that fits well with Touch’s own Lake Zone Initiative. Both programmes share a common goal – to increase health access and delivery to the Tanzanian people.
Given the prevalence rates here in Tanzania, one of our major priorities is tackling malaria, as it is by far the biggest health risk for our employees and local community members. By way of illustration, in 2008, Barrick Tanzania lost over 1,400 work days due to malaria. Our mine site teams have done excellent work in dealing with the malaria challenge through initiatives including distribution of insecticide-treated bed nets, effective case management and dissemination of prevention messages; at the same time we continuously look for innovative solutions to tackle the malaria challenge. As such, in collaboration with the District Health authorities in Kahama District, we have been developing a comprehensive malaria control program based on Indoor Residual Spraying. This is a pilot project focused on the community around Bulyanhulu, our largest mine site in Tanzania. The program will also include mentoring of health care providers working in the government hospitals near the mine in effective case management. It will also involve revamped efforts to deliver effective malaria control messages to the community.
Given the health challenges in Tanzania, the development of effective challenges is the most effective way in which the private sector can assist in the provision of sustainable health care programs and facilities. Leveraging resources and key competencies to form public-private partnerships is one powerful part of the solution as is being demonstrated by the Touch Foundation’s work with government institutions and Barrick in Tanzania.
Stephanie Hanson – A Disease of the Poor
Photo from the Siaya District Hospital. Credit: Sean Harder/The Stanley Foundation.
By 10 am, the women are lined up at Siaya District Hospital, row after row, each one with a sick child nestled in her arms and a look of resolve on her face. Some of them have walked for hours to reach the hospital, but they all wait patiently for the line to snake forward and deposit them in front of a physician’s assistant, who will weigh their child, take preliminary information, and send them to another row of wooden benches, where they’ll wait to see a clinical officer who can diagnose what is wrong.
More often than not, the children have malaria, the disease that kills approximately one million people a year, the majority children under five in Africa. Many hospitals don’t have this intake procedure, which allows the identification of acute cases that need immediate attention. While I’m observing the progress of the line, Dr. Mary Hamel notices that a tiny boy in bright red pants is breathing heavily, a sign of respiratory distress that could be a severe case of malaria.
Hamel is the co-principal investigator of the Phase 3 malaria vaccine trial run by KEMRI/CDC, a collaboration between Kenya Medical Research Institute and the U.S. Centers for Disease Control. She pulls aside the head nurse on duty and asks her to take a look at the boy. Forty-five minutes later, he is sitting in the acute care ward receiving treatment for severe malaria. This little boy is just one of many who suffer from malaria in western Kenya. If the Phase 3 trials go well, a malaria vaccine could be available for these children as soon as 2012.
Everyone who works on malaria — from researchers to government workers to doctors to economists — will tell you that malaria is a disease of the poor. What only became clear in recent years, and what I saw firsthand as I traveled throughout Kenya, was that malaria is just as much a cause of poverty as a symptom. Malaria costs Africa $12 billion a year. That is more than all the aid flows to the continent combined. An Africa without malaria would be a continent in which mothers don’t have to leave their other children to take one to the hospital, a continent in which adults wouldn’t have to miss work for one-week stretches to fight off their latest bout with the disease. It would be a place in which mothers could feel more confident that their babies would live to become adults, a place in which these mothers would have fewer children because they know they’ll all survive. Much attention, and money, has been devoted by Western donors to the treatment and prevention of HIV/AIDS in Africa. Yet helping to reduce malaria is one of the most cost-effective–and tangible–ways the West could help Africa achieve economic growth and prosperity.
Stephanie Hanson traveled to Kenya on an IRP Gatekeeper Editors’ trip organized by the International Reporting Project (IRP) in Washington, DC. She is the Associate Director and Coordinating Editor of the Council on Foreign Relations’ website, CFR.org.
Emily Bell — TB and malaria remain major killers in Tanzania
For the month of August, the Who Cares? Campaign will focus on how malaria and tuberculosis impact the healthcare system in Tanzania.
Often the stepchildren to HIV/AIDS, malaria and tuberculosis collectively kill nearly three million people each year. In Tanzania alone, malaria and TB account for nearly 22% of the disability-adjusted life years (DALY) loss. Significant investment has been channeled into vertical initiatives – addressing the specific diseases rather than the entire health system – to target these diseases, achieving mixed results. The Touch Foundation’s recent diagnostic study, Catalyzing Change- Molecular strengthening of the health system in the Tanzanian Lake Zone, reveals that such investment is compromised, in part, due to the lack of integration to the existing health system.
With malaria, for instance, the lack of diagnostic equipment and limited health worker training severely inhibit effective treatment. Due to its fast and short life cycle, malaria needs to be diagnosed quickly- getting treatment in the first 48 hours of the disease often means the difference between life and death. Without diagnostic tools and with only poor access to health facilities, this window of opportunity can easily be missed. During the onset for malaria, for example, frequent misdiagnosis occurs due to lack of laboratory access. The study also reveals that only 26% of dispensaries have blood smear testing to properly diagnose for malaria and during the treatment phase; nearly 40% of the health facilities lack second line drugs needed to properly treat malaria.
Though vertical investment in both malaria and TB has made impact in Tanzania, it is clear that significant opportunities exist for focusing on Tanzania’s health systems, particularly on human resource capacity in which to optimize such vertical investments. The World Health Organization estimates the current deficit of health workers in Tanzania to be around 90,000. Join the Who Cares? Campaign today to help us address this deficit and to put a stop to malaria and TB.
Emily Bell is Head of Advocacy and Communications at the Touch Foundation.
Omare Boniface Atandi — Perspectives of a Medical Student
Omare Boniface Atandi- Bugando Medical Student
Born in a poor family with no hopes, I grew up in one of the local villages in the country, which was faced with natural disasters. Life would seen to be normal even though people were dying of diseases that can be cured, but because of lack of doctors and personnel, dying was a daily song.
When I was 9 years old there was an outbreak of cholera, an epidemic that is due to contamination of fecal matter and people in my village died from this. Humanity was in no man’s mind because of lack of personnel — i.e., doctors or nurses who could identify the disaster and save lives.
I decided to become a doctor when I was 10 years old, knowing that the chance to become one was zero because of financial problems. What hurt me most was when I watched close family members die because of lack of access to treatment. You might not understand, but the truth is there was no doctor or hospital facility to assist them.
My neighbor died while delivering on the roadside next to our house while I was watching her without help. People doing traditional circumcision, too, both girls and boys without any knowledge on what they were doing would bleed to death. I remember seeing my moth put cow dung as treatment after locally cutting an umbilical cord from a baby! And you can imagine what most of the outcomes were. But neither you nor I can blame them!
After performing well in my advanced secondary school, I was like the hero in my village community, but remember I knew nothing about health except the concepts I had learnt in biology and chemistry. I was supposed to join university to do medicine (MD), but it was absolutely impossible because money was needed to pay fees, accommodation and food. I was really hurt, I remember spending around six months in deep stress trying to look for sources of fees, but it was all in vain.
I got a person in the city who told me he would only help me study clinical medicine (diploma in medicine) in order to help people in my village which I did study for 3 years in one of the colleges. After that, I became a clinical officer and started helping people greatly in my village and even in the next seven villages because I was the only clinical officer (not doctor) for more than 5,000 people.
I was moved to a mission hospital built by the Netherlands government in coordination with the Catholic Church where I worked for quite some time.
But the problem is there were so many diseases that I didn’t know just because I wasn’t a fully qualified doctor.
After I heard of the Touch Foundation in Weill Bugando University College of Health Sciences, I applied and really prayed for God to help me to be chosen.
To me, it was a miracle. It was the first time in my life to see a miracle. I was admitted to Weill Bugando University and up to now I am through my first year. To my village and local mission hospital, it’s a celebration and during this holiday vacation I am going back to continue treating them.
I wish that you all could come and see what you have done to us. We are now an asset to our communities and even to the whole country.
This is just a summary of my story, it’s too long, and I have photos that will make you know the complete story.
Presently, because of your contribution I am studying comfortably and I see a future working back in my home village and improving Tanzania.
Steve Justus, MD–Trauma: The Hidden Epidemic
Sitting around the table, doctors from Weill Bugando Medical Centre, the second largest hospital in Tanzania, were discussing the barriers to effective trauma care at their institution. One of those barriers was the lack of an available emergency theatre. This results in an unacceptable delay in life saving intervention.
The question asked was: “Why?”
An insightful intern observed that an emergency theatre was set aside for caesarian sections. He stated that the hospital was required to report their maternity mortality statistics in detail to the Ministry of Health. The fact that maternity mortality is a high priority (and rightly so) for the Ministry is reflective of the priorities of international funders. No one could argue that maternal mortality should not be a priority.
During my first week in Tanzania, an orthopedic surgeon approached me about his dream for the hospital to become a trauma centre. His first step was to create a trauma registry.
In health statistics published by the World Health Organization for Tanzania, road traffic accidents are listed as one of the top ten causes of death, just behind syphilis.
Really? More people die from syphilis than road traffic trauma in Tanzania?
Paradoxically, it has been demonstrated that as a country makes economic progress, more people die from trauma. This can be understood by anyone driving on the tarmac roads of Tanzania, where speeding SUVs share the road with push carts, animals and children, or by anyone like myself, who has worked in a casualty ward observing mothers whispering quietly to their whimpering children with open wounds and deformed legs. These children lie patiently on stretchers between casualty beds, each containing two or more patients waiting their turn for medical attention.
Other published data from sub-Saharan Africa list trauma mortality in the top three to four causes alongside HIV, malaria and TB.
So what are the take home lessons? A couple of clichés will suffice. You can’t manage what you don’t measure. Follow the money.
The orthopedic surgeon was right on target when he suggested a trauma registry as a first step towards his dream of a trauma centre at Weill Bugando Medical Centre. Good data could establish the burden of trauma in Tanzania. Should this data establish what seems anecdotally true, then the need to address the high burden of death and disability from trauma will become apparent. Leaders within th
e Ministry of Health, the private sector and international non-governmental organizations must then step forward to address this need.
Dr. Steve Justus has spent 22 years as an emergency physician in North Carolina. In August 2008, he joined our efforts at Weill Bugando. His position in Tanzania is supported by a grant from the United States Government’s Agency for International Development (USAID).
Kavisa Cyprian- Returned Peace Corps Volunteer in Tanzania 2006-2008
Imagine the sun rising over the desert ground in Mahongo, and the beauty of Tanzania. Lights scatter displaying colors not normally seen in a sunrise. In a place where electricity is sparse and unreliable, the sun dictates ones day. As the sky lightens I notice dozens of villagers lining up outside the mobile health clinic. They had walked hours in the dark, anxious to see the doctors and receive free medicine.
We leave the lush and fruitful town of Mbeya at 5 am. The Mbeya region, where I live in a hilly village called Tukuyu. It is a place where it rains so often that if you were to throw uncooked beans out your backdoor they would sprout days later. Three hours later, the bus drops us off in a place I did not know existed in Mbeya. The land is so barren I cannot fathom how the Tanzanians, 80% of whom are farmers, survive.
I watch as children as young as 4 arrive by themselves seeking medical help. I try as best as I can to explain complicated doses to these children, grateful when I see that some are accompanied by their grandparents only to learn their elders can not read either. The day alternates between heartbreaks and laughter; shocking things like a baby infected with herpes from birth or dozens of extremely malnourished people. I share jokes with one old grandma about the condom demonstrations I was giving. We light-heartedly discuss the cucumber I was using as a “model.” People are so happy to receive medical care that it puts them in an optimistic mood. This attitude of hope, I will never forget.
The need for accessible medical care in Tanzania is palpable. When I read articles in the NY Times about the high maternity related death rates, it makes my heart heavy because I know the stories are true. However, there is hope. For example, The Olive Branch for Children has expanded its mobile clinics and community services in Mahongo and organizations like The Touch Foundation are working to train thousands of health works. Medical care does not have to be determined by where you were born.
Andreas Mauer , M.D.- Bugando Medical Center Volunteer
I had the privilege to work at Bugando Medical Center as a visiting physician during my 3rd year of medical residency during the summer of 2007. The experience was among the most meaningful of my life.
The most immediate reason for this significance was the obvious need. The simplest way to describe the enormous need for Tanzanian doctors is this: there were more internists-in-training at my hospital in New York City than in the entire city of Mwanza. In fact, there were more pediatricians at my hospital than the entire nation of Tanzania! Given that infectious diseases like HIV and Tuberculosis are epidemic in the developing world (about the same proportion of Tanzanians have HIV as Americans with high blood pressure), that Tanzanians suffer from diseases like Malaria that most Americans will never even think about, and that Western illnesses like diabetes and heart disease are on the rise there, this lack of doctors is even more devastating than one might fear.
Yet, though they had few resources – inconsistent access to laboratory and imaging tests, power outages, and overcrowded wards with some patients sleeping two to a bed – the determination and idealism of the Tanzanian doctors and medical students was never less than inspiring. All expressed, consistently and generously, a desire to improve quality of and access to healthcare in Tanzania. Above all, it was their courage that made my time in Mwanza a life-changing experience.
I taught (and learned from!) many students, assistant medical officers, and junior doctors at Bugando. Together, we treated many patients. One patient in particular stands out: S., a young boy. At Bugando, the shortage of pediatricians meant that children above the age of twelve were admitted to adult wards. When I first saw S., my first thought was that he couldn’t be over the age of 8. An AIDS orphan, raised by his brother, his growth had been stunted by years of chronic illness. He came to Bugando with meningitis, a severe infection of the membranes of the spinal cord. He was feverish and unconscious but still screaming in pain. Together, the Bugando doctors and I performed a spinal tap, analyzed his spinal fluid, and instituted treatment. A week later, S. walked out of the hospital. Shortly thereafter, he attended Bugando’s well-run outpatient HIV clinic to receive the antivirals that I hope will help to keep him healthy for many years. This story has stayed with me because I think that, prior to the Touch Foundation’s involvement with Bugando, I think it is probable that S. would have died. Without the exchange of learning between American and Tanzanian doctors and students that Touch has made possible, there might not have been a doctor to see S. Without Touch’s infrastructure support, vital laboratory tests and antibiotics might not have been available. So while my time in Mwanza was immensely gratifying on a personal level, it was only possible thanks the incredible persistence and dedication of Bugando’s physicians and the support of the Touch Foundation.
In short, something exciting is happening at Bugando. Something that will have, and has had, a real and major impact on the lives of Tanzanians. I can’t wait to go back.
About the Author:
Andreas Mauer earned his M.D. from the University of Chicago Pritzker School of Medicine in 2001. He completed residency in Internal Medicine at New York Presbyterian Hospital Weill-Cornell Medical Center and is currently pursuing a Master’s Degree in Clinical Investigation at the Rockefeller University.
Matt Fitzpatrick- Personal Story by a Volunteer
Working with the Touch Foundation’s Young Leaders group has been one of the best experiences I have had since coming to New York City. I have had the opportunity to plan numerous charity events ranging from parties at nightclubs to performances at the Rose Theater. Through the Young Leaders group, I have met and become friends with numerous
intelligent, interesting, fun, and socially conscious people. But more than that, as a young person who spends much of my time on such mundane activities as editing spreadsheets in a glass cubicle, working for this cause provides an opportunity to help make a positive impact on the world, and to be a part of the solution for one of the great problems of our time – the health crisis in sub-Saharan Africa. I look forward to continuing my efforts with Young Leaders through the newly launched Who Cares? Campaign.
I first became interested in African healthcare infrastructure development, and African economic infrastructure more broadly, during a class I took in college called “The Politics of Developing Countries.” In a piece we read by Jeffrey Sachs, he argued that Africa’s economic development has been stagnated by a combination of a land-locked geography, a prevalence of diseases such as malaria, a harsh climate and large expanses of arid land, and the impact of European colonialism, among other things. These factors have resulted in a continent that lacks basic core infrastructure in several areas essential to economic development (e.g., healthcare, highways and roadways). For some reason this stuck with me more than anything I had read previously on Africa, as it so effectively explained the fundamental and systematic impediments to African economic development. I decided then that this was an area where I wanted to contribute in the future, but given the broad range of Africa’s infrastructure needs, and its complex web of public and private investment support, it was difficult to know where to begin to try and make a difference.
Two years later, fresh out of college, I was introduced to the Touch Foundation, the nonprofit that runs the Who Cares? Campaign, through a colleague at McKinsey & Company, and it seemed like the perfect organization to fulfill my earlier interest for 3 main reasons.
First: the cause. Healthcare is truly the most pressing and immediate need in Sub Saharan Africa. The health toll of HIV/AIDS, malaria, tuberculosis and other infectious diseases in the region is staggering, and perhaps most disturbing is their impact on children. Each and every day, over two thousand children in Africa under five years of age die of malaria, a preventable and easily treatable disease. To put that in perspective, since you began reading this note, almost 10 such children have passed away, never getting the chance to experience life or realize even the beginnings of their potential.
Second: the scope and approach. Many organizations aim big and accomplish little, as bureaucracy and a lack of accountability result in impact felt a mile wide and an inch deep. The Touch Foundation, on the other hand, focuses on a single country in Africa (Tanzania) where the healthcare infrastructure is particularly dire, with the goal of driving deep, lasting, and systemic change. In close partnership with the Tanzanian government, the organization is attempting to transform medical education in Tanzania and train a generation of new healthcare workers to serve as the foundation for an improved medical system, establishing a model that can be replicated throughout the rest of Africa in the future.
Third: the impact of my time and money. “Return on Investment” is a phrase used frequently in my field. The question is not simply whether every dollar spent will have an impact, but where will it have the greatest impact? In Tanzania, there is currently one doctor for every 33,000 people, compared to 1 doctor per 300 in the US. Training one doctor for a full 5 year program costs about $27,000, and training one pharmacist costs about $6,000. That means every event organized by the young leadership committee goes a significant way towards training a doctor that will be able to treat thousands of people that previously might not have received care, or covers the cost of training a pharmacist that will be able to distribute several thousand potentially life-saving medications. That means that every contribution by the young leadership team, big or small, can help to drive substantial, tangible, immediate impact.
And on top of all that impact, working with Touch has been fun. I’ve met a great group of smart and interesting people, and planned and attended several great events. It has definitely been one of my best experiences since coming to New York City several years ago.