Village Health Works Dairy Project

Village Health Works Dairy Project

Burundi
Organization type: 
nonprofit/ngo/citizen sector
Budget: 
$500,000 - $1 million
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

Village Health Works strives to bring social justice through access to high quality health care for all as the path to progress and dignity. VHW was founded upon the belief that health is a pre-requisite for any society to be self-sufficient and peaceful. Our global health and development programs bring lasting change to the world’s most impoverished and vulnerable people. With the knowledge that health is intrinsically tied to adequate diet, Village Health Works recognizes that food is medicine and works systemically to address endemic malnutrition in rural Burundi. Our Food Security Program (FSP) works with members of the community in a wide range of agricultural training and development initiatives aimed at empowering community members to sustainably feed their families and communities.

About Project

Solution: What is the proposed solution? Please be specific!

The Food Security Program is the only one of its kind in the region seeking to systemically address endemic malnutrition and poor health. Our program pioneers innovations in empowerment, access, and sustainability in the following ways: First, our project is entirely community driven. The direction and implementation of our programs are created through direct collaboration with the community. We alter our priorities as the community conveys their needs through daily interaction and planning events like our annual Kigutu Health Forum. Second, our creation of agricultural cooperatives is a unique and innovative approach to improving access by overcoming capital, resource, and market impediments that lay at the root of the regions poor nutrition to begin with. Working with cooperatives allows for higher efficiency in outreach, training and monitoring, diffuses the risk of economic ventures, and builds social capital. Third, select FSP students are trained as Agricultural Extension Agents (AEAs) who travel to the cooperatives and home gardens to help ensure proper implementation. AEA’s receive a new source of income along with additional literacy and teaching instruction. Through empowering AEA’s, the sustainability of the program increases through added buy-in incentives, increased educational spillovers, and expanded impact. The program also increases environmental sustainability through the introduction of organic farming and pest control practices, which improve the health content and lower the production costs compared to current widespread practices.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

The Food Security Program seeks to improve local diet through nutrition and agronomic education programs with a goal of diversifying and increasing crop yields in vegetables and fruits. The FSP utilizes a demonstration garden, 12 agricultural crew members, twice weekly agronomic training programs, and a seedling distribution program to promote the use of home gardens and improved agricultural techniques, as well as organizes community members into agricultural cooperatives. Participants now grow a variety of vegetables and fruits such as carrots, cabbages, onions, radishes, African eggplants, moringa, soybeans, tomatoes, beans, sweet potatoes, gooseberries, passion fruit, papaya, pineapple, and guava, among others. The FSP has also a nascent animal husbandry program of chickens and goats. All the harvests from the demonstration garden and animal husbandry programs are distributed to patients in our clinic’s malnutrition ward. The FSP would like to acquire 12 cows to use for demonstration in our communal garden. These cows will provide the genesis of the animal distribution program, provide manure to agricultural cooperatives and fresh milk to the clinic’s nutrition ward. The milk currently used in the ward is an expense. An onsite dairy production would help reduce costs and improve the efficiency of the ward, thus allowing for expanded clinical ability and scope. Starting with this animal stock, VHW will be able to breed up to 11 calves, which will be donated to the agricultural cooperatives by end of 2013.
About You
Organization:
Village Health Works
About You
First Name

Gerard

Last Name

Nayuburundi

About Your Organization
Organization Name

Village Health Works

Organization Phone

917-546-9219

Organization Address

391 Broadway, 5th Floor, New York, NY 10013

Organization Country

, NY

Country where this project is creating social impact

, BR

How long has your organization been operating?

1‐5 years

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Innovation
What stage is your project in?

Operating for 1‐5 years

Tell us about the community that you engage? eg. economic conditions, political structures, norms and values, demographic trends, history, and experience with engagement efforts.

Burundi, located in Central East Africa, is a nation that only recently emerged from a devastating 13-year civil war. The World Bank’s 2006 Annual Report named Burundi the world’s poorest country. Today, it continues to be ranked one of Africa’s 10 poorest nations. Burundi currently has a population of just under 10 million people and less than 200 doctors. Access to healthcare is virtually non-existent for rural Burundians.
Agriculture supports 90% of the workforce—most people earn their living as subsistence farmers. However, civil war and overpopulation have led to the reduction of the subsistence economy, making the country a net-food importer. According to a survey conducted by VHW (March 2009), 53% of households in the surrounding area live on an income of less than $20 per month, and this is shared amongst an average household size of seven family members. Farming is reported by at least 87% of the community as their main work activity, with only 4% reporting a steady salaried job. A full 65% of families in Kigutu reported that they spent between one half and all of their monthly income on trying to feed their families. VHW’s catchment area also has a disproportionately high population of returning refugees. Prolonged stays in refugee camps put this population at higher risk for communicable diseases like TB and HIV. Since opening its clinic’s doors in 2007, the Kigutu community has been overwhelmingly receptive of VHW and its mission. At our 2011 Kigutu Forum community members flooded our clinic to hear speakers from around the world and make their voices heard.

Share the story of the founder and what inspired the founder to start this project

"We are not just building a clinic, we are building peace."–Deogratias Niyizonkiza
After the start of the Civil War in Burundi in 1993, third year medical student Deogratias “Deo” Niyizonkiza fled the terrible violence that overtook Burundi to New York City. He arrived penniless and without one word of English, but despite the hurdles– low-paying work, illness and homelessness— with help from new friends he eventually enrolled in Columbia University where he studied biochemistry and philosophy. Later, while attending Harvard University's School of Public Health, he met and worked with Dr. Paul Farmer, co-founder of Partners in Health. During his studies at Dartmouth Medical School, he took a hiatus to found Village Health Works. Since opening its clinic doors in December 2007, the clinic has seen more than 55,000 individual patients, the majority of whom are women and children. Deo is currently a finalist for the 2011 GQ Better Man Better World Award and the 2010 recipient of the Women Refugee Commission’s Voices of Courage Award, which recognizes individuals who have overcome immeasurable odds and give back to their communities. His story can be found in Strength in What Remains, the critically acclaimed book by Pulitzer Prize-winning author Tracy Kidder. The Food Security Program is a direct result of Deo’s desire to treat the root causes of illness, and has transformed from early ideas to the current full-fledged agricultural program through a dynamic interaction between the community, VHW, and international experts aimed at meeting the community’s most urgent needs.

Social Impact
Please describe how your project has been successful and how that success is measured

To date, our project has seen the training of 150 people in basic nutrition, the training of 500 in our agricultural program, the formation of 12 farm cooperatives and the treatment of hundreds of malnourished children. VHW uses a variety of methods to track success. We administer pre and post examinations to those who go through our agronomic courses. On average, 79% of students pass their final exam. To monitor home gardens and former malnutrition patients, we use home visits by our agricultural crew members, AEAs, and community health workers who keep a log of cases to monitor the effectiveness of interventions and causes for lapses in garden maintenance. For our agricultural cooperatives, we have developed monthly progress reports and forms and intend them to be financially sufficient after the first growing season. Our goal is to reduce the rate of catchment area households skipping meals due to lack of food from its current rate of 66% to 33% by the end of 2012.

How many people have been impacted by your project?

1,001- 10,000

How many people could be impacted by your project in the next three years?

More than 10,000

Winning entries present a strong plan for how they will achieve growth. Identify your six-month milestone for growing your impact

In the first 6 months, we will build the shelter and capacity to incorporate cows into our demonstration gardens and malnutrition ward.

Task 1

Construct cowshed and acquire 11 female cows 1 male cow for the Food Security Program

Task 2

Immediately incorporate the cow’s manure into our gardens and their milk into our malnutrition ward instead of buying the expensive manure and milk that is currently used.

Task 3

Re-appropriate the money formerly used for manure and milk for on-site garden and malnutrition ward expansion and activity intensification.

Identify your 12-month impact milestone

Within the first twelve months, we plan to begin fully realizing the productivity and efficiency gains from the Dairy Program.

Task 1

Reduce the FSP operation cost to 80% of its current level while expanding the size and scope of the demonstration gardens.

Task 2

Improve the overall soil fertility and productivity of our gardens through use of sustainable manure fertilization.

Task 3

Sell excess crops from increased crop production at market and utilize profits to help cover the costs of the Food Security Program.

How will your project evolve over the next three years?

Once the cows have been fully incorporated into the demonstration gardens, the animal distribution program will start after each of the cows have healthily gone through a reproduction period. We plan to be able to distribute 15 cows to 5 agricultural cooperatives by the end of the third year. The cooperatives will start using animal manure from their own cows, allowing them to realize the same benefits as the demonstration gardens— improved cost-effectiveness of their farming projects, freed resources for program expansion, and improved soil fertility and crop productivity. The health status of household members of agricultural cooperative member will improve through the addition of new sources of food nutrients and improved nutrient content of their current crops.

Sustainability
What barriers might hinder the success of your project and how do you plan to overcome them?

(1) Since the animal distribution program is new, the first distributions will have to be done cautiously and with regular monitoring by our community health workers and AEA’s along with close collaboration with the community. The initial home garden program had to be redesigned to ensure continued community enthusiasm and avoid old habits and norms. Since distribution will be done through our cooperatives, transition difficulties should be minimized through the cooperatives well established involvement with VHW, greater ability to pool resources and greater commitment to the project.
(2) The introduction of new crops and animals must prove to be profitable. The current dominant crop in the area is cassava, which is cheap to grow but offers almost zero nutritional value. Four fifths of survey respondents would like to purchase field crops locally, and 85% would like to purchase vegetables, indicating a potential market for increased production. Currently, many agricultural crops are imported from villages 40-90 kilometers away; demonstrating clear opportunity in the local markets for nearby cooperatives to sell their produce.
(3) Many returning refugees have no land or the land they left has long since been reoccupied. The use of cooperatives where members join individual pieces of land and donating some of VHW’s land is seen as the best way to properly and justly pool land and labor resources to maximize efficiency.

Tell us about your partnerships

VHW’s most important and robust partnership is with the community we serve. VHW is community-focused and community-driven. Local leaders and the community are incorporated in all stages of planning and project development. Additional key partners include the Burundian Ministry of Health, the U.S. Embassy within Burundi, Partners In Health, International Refugee Committee, Columbia University, the U.S. State Department Office of Population, Global Health Corps, Refugees and Migration and Hebrew University of Jerusalem, among others.

Explain your selections

VHW’s FSP has a broad and diversified base of support in both the US and in Burundi. In the US, VHW relies on a strong base of supporters consisting of approximately 1,500 individual donors. VHW also partners with a wide range of family foundations as well as funding from the U.S. government.
Further, VHW enjoys a wide range of support in Burundi. The Burundian government currently funds a portion of our pharmaceutical needs as well as 50% of the salaries of our clinical nursing staff and we look forward to expanding this relationship in coming years.

How do you plan to strengthen your project in the next three years?

VHW plans to strengthen its project through building on our excellent staff, expanding our available resources, and expanding our ability to provide total health care.
First, we seek to strengthen our team through continuing to attract high quality staff from the community we serve. We want to empower committed, compassionate, and competent community leaders as members of our clinical and community development teams and as operational support staff. Concurrent to this, we wish to continue to expand and build our New York City team to focus on development and communications in support of our team in Burundi.
Second, we will develop our resource base through growing our body of supporters within Burundi, the East African Region, and beyond; build key strategic alliances in the areas of health, education, and economic development; and explore income-generating ventures by utilizing unused portions of land to support operating costs.
Third, we will provide the benefits of complete health by not only treating illness and disease, but by permanently uprooting their very causes. In pursuit of this, we will eliminate the need to transfer patients to other facilities for diagnostic tests, increase the quality and quantity of our education outreach programs, increase our focus on women and their children as a way to build good faith within communities we serve, and partner with US physicians to provide quality, critical services such as eye and dental services that will allow the people of Burundi to live more productive lives

Challenges
Which barriers to health and well-being does your innovation address?
Please select up to three in order of relevancy to your project.

PRIMARY

Health behavior change

SECONDARY

Lack of access to targeted health information and education

TERTIARY

Limited human capital (trained physicians, nurses, etc.)

Please describe how your innovation specifically tackles the barriers listed above.

The Food Security Program’s primary goal is to overcome the educational, resource, and market barriers that have caused widespread malnutrition in Burundi. Through the acquisition of cows, the FSP will be able to expand its curriculum, reach, and capacity. The addition of the cows will increase the nutritional variety available to many in the village and provide a sustainable source of milk and fertilizer. Further, the cows will lower the long term costs of the malnutrition ward and Food Security Program, which will allow the ward to increase capacity and improve efficiency, which will in turn increase our ability to focus our health and agronomic experts on new tasks and challenges.

How are you growing the impact of your organization or initiative?
Please select up to three potential pathways in order of relevancy to you.

PRIMARY

Enhanced existing impact through addition of complementary services

SECONDARY

TERTIARY

Repurposed your model for other sectors/development needs

Please describe which of your growth activities are current or planned for the immediate future.

VHW must always expand its scope and services in a thoughtful and strategic manner to address the causes of widespread illness in Burundi. Health is the primary prerequisite for a happy and productive life, and no one better understands this than those who are afflicted. That is why VHW prides itself on its direct and constant community involvement. VHW seeks to constantly expand our services and abilities to meet the most urgent needs of our community as they are conveyed to us. Our goal is to train 25 community representatives every 6 months from villages within our catchment area, enroll 80% of the population within our catchment area to maintain year-round home gardens, reduce malnutrition incidence to 20% of its current situation, and triple vegetable, fruit, and grain production.

Do you collaborate with any of the following: (Check all that apply)

Government, Technology providers, NGOs/Nonprofits, Academia/universities.

If yes, how have these collaborations helped your innovation to succeed?

Village Health Works is proud to have collaborated with a wide variety of respected partners including Partners in Health, Columbia University, Global Health Corps and the International Rescue Committee. These partners have provided programming guidance, clinical training, administrative assistance, clinical equipment, solar power and communications equipment, strategic expertise and funding.

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