Local organizations say the scale of disaster in Pakistan is beyond comprehension: one-fifth of Pakistan is under water, 20 million people have been displaced and at least 900,000 homes destroyed.

While the floods have caused more devastation than previous disasters such as the Haiti earthquake or the 2005 earthquake in Kashmir, far less money is coming in. Relief agencies say they are running out of resources.

It's harder to raise money for disasters that play out over time rather than hit all at once, aid groups say. Another reason may reflect reluctance on the part of donors, including Pakistani-Americans.

Yet two Northwest organizations that suffered attacks recently in Pakistan have been among the first to rush to its aid.

K.M. CHAUDARY/ASSOCIATED PRESS

Villagers in central Pakistan flee their homes last week due to heavy flooding.

Federal Way-based World Vision now has a team in place in Pakistan that is working to provide water, hygiene, shelter and food to 300,000 people in areas hardest hit by the flood. It has opened five emergency health clinics to treat people with waterborne diseases, and hopes to offer cash for work programs and set up safety shelters for women and children.

Mercy Corps, headquartered in Portland, says it is working in the Swat Valley to provide clean water to 25,000 people a day via water tanks, high-volume filtration units and water purification tablets. Its 20-person team is also distributing food kits and tools to help in the clean up. The organization plans to expand relief efforts into Sindh Province.

World Vision and Mercy Corps both suspended operations in the country following attacks earlier this year. Six World Vision Pakistani staff members were killed in March when gunmen stormed their offices in Mansehra, and four Mercy Corps Pakistani workers were abducted in February on the road near Quetta. One was later killed and the other three released.

With a 24-year history in Pakistan, Mercy Corps resumed operations just days before the floods hit, said spokesman Joy Portella. Its aid workers in the Swat Valley led the way, saying
'"We have to respond to this," she said, but getting restarted has been very emotional.

World Vision estimates it will need $20 million to respond to the disaster.

Early on, "it was unclear just how massive the needs were because it was difficult to reach some of the hardest-hit places," said Randy Strash, the group's fundraising expert for disaster response. "Now, we know that millions of children and families need our help."

So far it has raised $478,000 in private donations in the U.S. and is applying for more in government grants, and a total of $2.8 million globally, less than 15 percent of its goal.

World Vision raised 50 times more for Haiti in the first two weeks after the earthquake than it has for Pakistan, Strash said, yet ten times as many people are now affected in Pakistan.

Other groups assisting in Pakistan include Medical Teams International, which is shipping medicines and supplies to the country, and the Jolkona Foundation, which works through a local partner called Barakat. Barakat works primarily in refugee areas with a focus on girls education.

Here is a searchable database with more information on groups working in Pakistan.

Look for a story by Seattle Times reporter Janet Tu later this week on local community efforts to help.

Ambitions to solve problems of poverty are at an all-time high, especially among organizations dedicated to global development in Washington state. But the public appetite to finance them is not.

The U.S. will have to get more results out of the money it's spending and find innovations that come from technology to help bridge the gap, USAID Administrator Rajiv Shah told a Seattle audience this morning. He spoke to a packed crowd inside St. Mark's Cathedral at an event sponsored by Global Washington.

Shah, the former Gates Foundation executive tapped by President Obama to head international development, has brought the foundation's well known focus on measuring results to the government arm responsible for more than $20 billion in foreign aid.

The administration is living up to its commitment to double the foreign aid budget, he said. But to do that it must prove to taxpayers that the resources are used effectively and that seemingly intractable problems can actually be solved.

"If we can continue to show things are really effective, generate results with the dollars and take efficiency very, very seriously, I believe Americans want to do more," he said.

Shah issued a call to action to Washington state, known for its role in technology, to contribute innovative ideas.

He described a vision of the future in which science and technology, in the form of a tablet computer with an Internet connection, could help a farmer in a remote village get access to information such as market prices, and send photos of pests or diseases outside in asking for assistance.

Chris Elias, chief executive of the Seattle health non-profit PATH, cautioned that it's a mistake to equate innovation with technology. "Too often we think of it in terms of the gadgetry," he said. "You can't do a C-section through a cellphone."

The U.S. is contributing to health problems in places like Africa and India by encouraging the best trained doctors and nurses to leave and work here, said Rep. Jim McDermott, D-Seattle .

"We are sucking that brain power and leaving a huge vacuum in the third world," he said.

Shah said one of the ways the new evidence-based approach has improved programs came from recent efforts to assist Haiti. To boost access to safe water, USAID made it mandatory for trucks providing fresh water supplies to also distribute chlorine tablets to Haitians. Diarrheal disease is now 12 percent lower than it was the day before the earthquake, he said.

Marla Smith-Nilson, executive director of Seattle-based Water 1st International, said she was pleasantly surprised at the forum's message, but she still wanted to hear more about developing human capacity and stronger communities.

"I don't think there's any technology that is going to replace neighbors talking to neighbors about the importance of washing hands and the importance of actually using toilets," she said. "There's nothing that fits in a box on a shelf that is sold in a marketplace that is ever going to replace that kind of learning about public health and behavior change."

Global health is a national security issue at the leading edge of efforts to reform U.S. foreign policy, a visiting State Department director told a Seattle audience.

Washington state is a center of those efforts to solve global health problems, part of a small but growing industry with good paying jobs and world-class research, Gov. Chris Gregoire and others said.

ARI SHAPIRO/ART DAUBER PHOTOGRAPHY

Anne-Marie Slaughter, director of policy planning at the U.S. State Department, speaking in Seattle.

The Washington to Washington dialogue, which took place at PATH Thursday, highlighted the connections between such national and local efforts. At a time when resources are falling short and many issues are competing for funds and attention, speakers made the case that continuing to invest in improving health of the poor is more than a moral issue. It also helps advance longer term security and development goals.

U.S. "smart power" diplomatic policy now means "focusing not just on what governments do, but on conditions of people within those countries" as equally important, said Anne-Marie Slaughter, director of policy planning at the U.S. State Department.

The president's six-year $63 billion Global Health Initiative is concentrating on the systems needed to improve overall health, rather than individual diseases, she said. Activists recently have criticized the Obama administration's lack of commitment to AIDS funding.

The principles are to do more of what has already proven to be effective, make the health of women and girls a priority, support entrepreneurial approaches to public health, focus on local country ownership and partner with other groups working on the same issues, Slaughter said. A report on Smart Global Health Policy recommended many of those points as part of a long term U.S. strategy.

A review process every four years will integrate the missions of the State Department and the US Agency for International Development and track progress.

Asked how to convince Congress to support the initiative over six years, Slaughter replied "by mobilizing the kind of communities we have here," including "interest among students to do something concrete in global health."

Gregoire said jobs in the life sciences pay on average twice as much as other jobs in Washington state and are "the kind of jobs we need in fields to reinvent ourselves." But the work is also driven by a basic humanitarian impulse, she said, adding "our cherished values of innovation are matched up with our value of compassion."

The next five years in global health is the most critical period. The world has five years left to achieve the Millennium Development Goals agreed to in 2001, but some hard won gains are slipping. "We have the fattest pipeline of new technology we've ever seen," said Chris Elias, CEO of Seattle health nonprofit PATH. But stronger health systems are required to deliver those solutions to people who need them, he added.

Some audience members attending the discussion said clean water must be a key part of any viable health program, since so many preventable diseases are caused by poor sanitation. It's easy to see how water is related to security. Yemen, fertile ground for Al Qaeda, is on the brink of running out of water.

The case of tuberculosis also shows how a disease all but eliminated here can come back and impact local communities. Multidrug-resistant tuberculosis, which has been diagnosed in the state, requires long-term, costly treatment. However, even with such emerging health threats, reports have found the state's public health system inadequate to perform essential functions without dedicated, stable funding.

News around this week's AIDS 2010 international conference has been coming fast and furious, with results showing a gel capable of blocking HIV, the promise of antiretroviral drugs to prevent infection, and earlier, the discovery of two naturally occurring antibodies that could help push the development of a vaccine forward.

COURTESY OF UW

Dr. King Holmes, chair of University of Washington Department of Global Health and director of the UW Center for AIDS and STDs.

Researchers, foundations and nonprofits in Seattle are playing a key role in the global response. Using cost effective methods to prevent and treat HIV/AIDS has emerged as a central theme.

King Holmes, who is chairman of the Global Health Department at the University of Washington and an expert on HIV and other infectious diseases, said that prevention has not previously received the emphasis it deserves. Two of the most important advances in prevention are microbicide gel and male circumcision.

A new study showed that an antiretroviral gel significantly reduces a woman's risk of being infected with HIV and genital herpes, according to a report by the Centre for the AIDS Programme of Research in South Africa (CAPRISA).

Holmes called it "the first clear evidence of the effectiveness of a new intervention."

And he pointed out that the Microbicide Trials Network is headed by Sharon Hillier, a graduate of Washington State University and former UW professor. She is principal investigator and leads an international team of researchers and community and industry partners from seven countries and three continents.

As part of that network, another important trial known as the VOICE study is expected to start next month, looking at whether some of the medications used to treat HIV can also be used to prevent it. Jeanne Marrazzo, University of Washington associate professor of medicine, is the study's co-chair.

Finding solutions appropriate for women is especially important. In sub-Saharan Africa, where the epidemic has hit hardest, 60 percent of adults with HIV are women. While male condoms are effective, women can't always control if and when they're used, and women are twice as likely as male partners to acquire HIV during unprotected sex. Seattle-based PATH is home to the Global Campaign for Microbicides.

Marrazzo said researchers in the VOICE study will also try to determine whether women are more inclined to use a tablet or a gel.

For men, three recent studies showed male circumcision decreased the risk of acquiring the virus by about 60 percent. "That really is unequivocal," Holmes said. However some doctors remain opposed to the practice.

To make progress with limited resources, all of the known defenses against HIV must be applied, focused on all groups at risk and better coordinated around the world, Holmes said.

"Although scaling up antiretroviral therapy globally has lowered mortality rates," he said, "the number of new infections occurring every year exceeded the number of deaths. This is clearly a prevention failure. as long as the cumulative number of people with HIV infection continues to increase... we are going to have a bigger and bigger problem."

More than 35 million people are estimated to be living with HIV worldwide. In 2008 there were about 2.7 million new infections, and about 2 million AIDS related deaths, according to UNAIDS.

Looking longer term, basic research to identify new targets for vaccines has also gotten a boost recently.

I asked Alan Aderem, co-founder of the Institute for Systems Biology and a renowned immunologist working on the vaccine side, how he interpreted the latest discovery of antibodies effective against HIV.

I had profiled Aderem earlier this month, looking at the passion for social justice that motivates his science. Before his career in biology, Aderem spent most of his youth as an anti-apartheid activist in his native South Africa, where he is currently coordinating vaccine trials.

JOHN LOK/SEATTLE TIMES

Dr. Alan Aderem, co-founder of the Institute for Systems Biology.

Here's his response:

"The latest discovery defines an immunological Achilles heel of the virus. It uses structural studies to identify an important target for broadly neutralizing antibodies on the virus and demonstrates that an antigen can be designed that elicits the appropriate host response.

This is particularly important given that the recent Thai trial identified antibodies as crucial for the, albeit limited, protective response. Perhaps the most important aspect of the discovery is the methodology which allows for rational vaccine design; the method will clearly enable vaccine development against other pathogens.

I am not sure whether the finding signals a renaissance in the field but it will certainly energize it."

Three of four Mercy Corps employees abducted in Pakistan in February have been released, Mercy Corps CEO Neal Keny-Guyer said today.

"We are very happy and relieved to inform you that three members of our Pakistan team have been released after nearly five months in captivity," he wrote in a statement. "All three are unharmed and are being reunited with their families in Pakistan."

Relief mixed with grief over the death of the fourth employee, a 52-year-old driver with nine children, at the hands of the kidnappers in mid-June. The group was abducted Feb. 18 as they were driving to an office in Quetta, in the southwest.

The BBC reported that pro-Taliban gunmen had sent Mercy Corps a videotape of the employee being murdered and demanded a ransom of $1.2 million or else the remaining three would also be killed. The report quoted Dr Saeedullah Khan, head of Mercy Corps operations in Quetta, saying the Pakistani government had done little to help free the hostages.

The three employees freed are Dr. Syed Asif Abbas, 50; Iftikhar Shafiq, 34, and Beeburg Suleman, 27. The men, all Pakistani nationals, were working with local district health officials in Balochistan province to implement health programs.

"While we celebrate the safe return of our three colleagues, we are still mourning the loss of our fourth abducted team member, Habibullah, who was killed by his captives earlier last month," Keny-Guyer said.

Mercy Corps learned of their release from their families.

"We don't know the identities of the abductors, or exactly why they were taken," spokeswoman Joy Portella said. Family members and tribal elders were negotiating with the captors.

As for the future of its operations there, Keny-Guyer said Pakistan programs are still suspended and undergoing review.

The Portland-based organization has been working in Pakistan since 1986 on health, economic development and emergency relief programs.

"While we remain deeply committed to the people of Pakistan, the safety of our team remains our number one priority," he said. "We need to ensure that, if our work continues, it can be done effectively and without putting our team at risk."

World Vision suspended its operations in Pakistan in March after gunmen attacked its offices and killed six Pakistani employees in Manshera district north of Islamabad.

The system of U.S. foreign aid is broken, Seattle experts on development issues say. Now local non-profits, businesses and educational institutions hope to have a direct impact on how it's fixed.

To start, the U.S. needs a national strategy to clarify the goals of foreign aid, trade policy consistent with those goals, an easier process for small businesses to participate and support for international education programs.

KRISTI HEIM/SEATTLE TIMES

U.S. Sen. Maria Cantwell (left) speaks to audience members at a forum on global development at Seattle University.

Those recommendations from Global Washington, a Seattle association of 120 groups working in the field of global development, were released today and discussed by U.S. Sen. Maria Cantwell and others in a forum at Seattle University. The full report is here.

Cantwell said she and Sen. Patty Murray requested the recommendations last fall and will take them to back to Washington D.C. to contribute to the ongoing debate over how the U.S. should change its policy for foreign assistance.

Among the problems: flooding the market with food aid from overseas and causing local crop prices to drop, and trade tariffs that end up costing poor countries much more than the aid they receive.

In 2006, for example, the U.S. gave $120 million in aid to Bangladesh and Cambodia, while at the same time collecting $853 million from them in import duties. This report has further details.

Effective foreign aid can improve economic conditions and help fight terrorism, Cantwell said. Though the U.S. contributes less than 1 percent of its federal budget to foreign aid, polls show spending on aid is unpopular nationally, she said. More accountability of the funding is needed to measure and show results.

Washington is home to about 200 non-profits working on global development issues in 144 countries, according to Global Washington. They include global health, clean water and sanitation, food security, poverty and education.

"These are some of the most basic and life sustaining issues that demand involvement of us as a nation and certainly involve us in Washington state," Cantwell said.

Global Washington recommended that foreign aid be aligned with United Nations Millennium Development Goals, that USAID have autonomy from the departments of State and Defense, and that aid be based on priorities of local recipients and proportionally targeted to countries that are the poorest and most in need.

"We have the technology, we have the people and the passion. We need a structure for coordinating it and measuring the impact," said Yvonne Harrison, assistant professor of non profit leadership at Seattle University, who helped write the recommendations.

Washington is uniquely positioned to comment, Cantwell said, with almost 5 percent of all Peace Corps volunteers, the highest percentage of any state, as well as America's most diverse ZIP code -- 98118 in Rainier Valley, where people who speak 60 different languages now live.

Seattle's impact on the other Washington is already being felt in the number of people with positions in the Obama administration, including former Gates Foundation agricultural development director Rajiv Shah, now head of USAID, former Washington Gov. Gary Locke, now Commerce Secretary, and Travis Sullivan, a former Boeing executive now Locke's chief policy advisor.

Maura O'Neill, Cantwell's former chief of staff, now works under Shah as chief innovation officer at USAID and spoke at the Seattle event.

"My role is to be on the hunt for new breakthrough ideas and put innovative partnerships together," she said.

One of them was a $10 million partnership USAID recently announced with the Bill & Melinda Gates Foundation to develop mobile banking in Haiti. O'Neill said the project may be expanded globally.

Another is a USAID partnership with Coca-Cola to connect Haiti's mango growers to the drink maker's supply chain to provide juice for drinks under the Odwalla brand, she said.

USAID is working with U.S. companies in Indonesia, the third largest carbon emitter in the world, to develop new business models to reduce deforestation for palm oil production.

A new website connects lawyers who want to volunteer time with non profits and social entrepreneurs looking for free legal services.

TrustLaw Connect is an online service promoting pro bono legal work around the world. It works a bit like Kiva in that people requesting and people donating help are vetted and then matched through the service, which is run by the Thomson Reuters Foundation. It's free to both beneficiaries and providers.

More than 60 law firms and 80 non profits have signed up, including Seattle-based Teachers Without Borders. For social entrepreneurs, however, the service doesn't accept unsolicited proposals. Instead it works by referral from organizations such as Ashoka, the Grameen Foundation, the Hewlett Foundation and the Skoll Foundation.

Examples of the kind of work it supports are writing legal documents, advice on intellectual property, governance, drafting funding agreements, negotiating contracts and advice on charity laws. Lawyers Without Borders offers a similar service.

TrustLaw says it doesn't help with litigation against individuals, companies or governments, which may limit its impact. Still at a time when nonprofit resources are constrained, getting professional services donated could save valuable funds for programs.

The foundation said its overall aim is to improve access to the rule of law and greater transparency. The site is also devoted to news and information about anti-corruption activities around the world.

Next Tuesday Global Washington will release its recommendations for revamping U.S. foreign assistance from a panel of 45 local experts.

It's a good time to talk about strategies for improving aid after last weekend's meeting of G8 leaders, which many non-profit groups say failed to adequately fund basic programs to prevent the deaths of mothers and their newborns.

KIER GILMOUR/MCCLATCHY NEWSPAPERS

Protesters demonstrate on stilts while wearing masks portraying G8 leaders in Ontario, Canada, as the summit meetings began.

Humanitarian organizations had urged leaders of the eight wealthiest nations to double their collective spending on maternal and child health to $20 billion over five years, saying the money could save a million children a year and more than 200,000 mothers.

What the group offered was $5 billion over five years, with an additional $2.3 billion from others. The Gates Foundation is picking up most of the private tab with its $1.5 billion pledge, the second largest in its history.

"With economic uncertainty and the massive Gulf oil spill taking a significant toll in the U.S., it's not a shock that President Obama and other leaders shied away from greater commitments at this summit," said Robert Zachritz, director of advocacy for Federal Way-based World Vision. But it's shortsighted, he added. "Investing in global child and maternal health yields a high return for a tiny fraction of the sums spent so far on financial bailouts."

Politicians are absorbed by the world financial crisis and other mounting problems at home, and skepticism about the effectiveness and impact of U.S. foreign assistance has grown.

SCOTT OLSON/GETTY IMAGES

A highlight of the G8 meeting was the Muskoka Initiative to save 1.3 million children; a low was the funding to do it.

One lesson in all this may be that guilt doesn't work as effectively as self interest. Investments in global health in fact are an economic stimulus, argues Jack Chow, a CMU professor and former U.S. health ambassador under Secretary of State Colin Powell.

The combination of rising diseases and economic uncertainty calls for a new approach that can address both, he said.

"The G-20 leaders should recognize the connection between health and long-term economic security in both developing and developed countries," Chow argues. Healthy workers are more productive and can save more for food and medicines. Sound economies, in turn, permit greater investment in health." And, he might add, eventually buy the products that ailing economies like ours are making.

Chow suggested combining the two aims by promoting a health-jobs package for the poor, supported by alternative funding sources from the reserves of oil-rich and Asian exporting nations.

In Seattle, global health and biotechnology are important sectors that continue to add jobs in spite of the recession and inspire a generation of young people to tackle some of the world's toughest challenges.

One of the main recommendations of Global Washington is for the U.S. government to streamline the process for businesses, especially small businesses, to get involved in public-private projects designed to boost health and development in emerging markets. Trade policy should also be linked to development objectives, the Seattle non-profit argues.

Tueday's discussion will include examples of successful development partnerships in Washington state, with Sen. Maria Cantwell and Dr. Maura O'Neill, chief innovation officer at USAID, participating.

World Vision, whose foundation is faith-based, also uses economic terms to get its point across. It estimates that $15.5 billion in potential productivity is lost each year when mothers and babies die from preventable causes such as malnutrition and lack of basic health care. Each dollar invested in global health would create a $3 gain through extended healthy lifespan and faster economic growth, the organization says.

World Vision estimates it will spend $1.5 billion on child and maternal health over the next five years, making health a greater priority throughout its programs. The organization has an annual income of about $2.6 billion.

Large pharmaceutical companies have several reasons to promote their efforts to provide better access to medicines in the developing world.

Their image has been tarnished by actions that kept patented drugs away from poor countries in the past, and now their ailing business depends on growth in emerging markets. Two billion people in the world still lack access to essential medicines.

An index funded by the Bill & Melinda Gates Foundation ranks pharmaceutical companies based on how well they are performing in research, pricing, patenting and donations to improve access for the poor. The index aims "to give industry a voice and a platform to design their access to medicine programs," according to a statement on the organization's website.

GRANT ERSKINE/ASSOCIATED PRESS

A giant AIDS ribbon is erected in Durban, South Africa. South African pharmaceutical company Aspen Pharmacare began producing the first cheap generic copies of major AIDS drugs in Africa seven years ago.

Run by a Netherlands-based foundation, the Access to Medicines Index compares 27 companies, including those that make generics.

The research work is done by the RiskMetrics Group, based on interviews, corporate documents and publicly available information. Much of the data is provided by the companies themselves, which makes some analysts skeptical about its integrity. The foundation says as public companies they have no incentive to provide inaccurate information to the marketplace. (But that hasn't stopped them in the past.)

The project aims to encourage transparency and cooperation between the companies and "combine the goals of science and business" to improve health.

In this year's rankings, European pharmaceutical companies performed better than their American counterparts. However, U.S.-based pharmaceutical companies are doing more than they have in the past to make medicines available to people in developing countries, the report found.

One way companies may seek to use the ratings for their advantage is in recruiting. News that UK-based GSK had achieved the top ranking in research geared toward needs of developing countries has already been posted on a pharmaceutical job site.

By Sandi Doughton

Funding for programs to boost health around the globe has continued to increase over the past few years, despite the economic downturn.

But the growth is unlikely to continue much longer, said Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington.

An earlier analysis by Murray and his colleagues found that spending on global health programs quadrupled between 1990 and 2007, from $5.6 billion to nearly $22 billion.

The upswing was partly fueled by wealthy, private donors, including the Bill & Melinda Gates Foundation. The total includes funding from developed nations, corporations and NGOs.

But Murray said Thursday at IHME's annual board meeting that the previous report was outdated by the time it was released last year.

An update shows that funding climbed to $23.6 billion in 2008. Murray estimates it will hit about $29 billion this year.

Economic modeling predicts that the effects of the global recession will start to be felt in 2013, when total spending will probably dip, he said.

Founded with a $105 million grant from the Gates Foundation, IHME's mission is to bring rigorous statistical analysis to the evaluation of health programs and trends worldwide.

But the institute's work, which has uncovered exaggerated childhood vaccinations rates and undermined UNICEF claims of rapid declines in child death rates, has earned it animosity.

Dr. Richard Horton, editor of the British medical journal The Lancet -- which has published many of IHME's studies -- read the board members a scathing e-mail he received from another global health scientist, angry that Murray and his team were viewed as a "conquering hero," while those who have worked for decades on the front lines of global health are now portrayed as villains.

Horton urged IHME to reach out more to its critics, perhaps by sponsoring an annual conference focusing on global health science.

Ethiopian Health Minister Tedros Adhanom Ghebreyesus, a member of IHME's board, said the institute wouldn't be doing its job if there was no controversy about its work. But he suggested IHME make its work more useful to developing nations by tailoring analyses to individual countries.

There's a point at which a cluster of organizations working on a problem starts to feel like more than the sum of its parts. That kind of multiplier effect fueled Silicon Valley's technology innovation for decades.

Is it also starting to help Seattle gain traction solving problems in world health?

When people in their twenties decide to throw a party to fight rotavirus, and more than 500 guests show up (with 200 more on the waiting list), something new is taking hold.

ARI SHAPIRO/DAUBER ART PHOTOGRAPHY

Hope Randall, program assistant at PATH, demonstrates an oral rehydration kit that can save children from death due to diarrhea.

"We can change the world every day, in everything we do, even partying!" was the optimistic mantra.

Who knew that one event in Seattle could help a country achieve a national health goal? (The event raised $13,000, enough money to fund Kenya's oral rehydration program). Who knew that childhood diarrhea would be the topic of conversation at a cocktail party?

"Diarrhea Happens" was the way one of the hosts, Anne DeMelle, summed it up in a Facebook entry for Party with a Purpose. "It's true - it happens even to the best of us. For a half a million children around the world every year this seemingly benign condition is caused by a preventable virus and kills them. But it doesn't have to."

Lacey Birk, 25, said she and roommate Kristen Eddings knew rotavirus was a good cause. Though they wondered: "Are we really ready to talk about diarrhea with all these people?"

KRISTI HEIM

PATH communication officer Deborah Phillips talks with party guests about rotavirus and other health issues.

The efforts of people working in the field are getting bolstered by students and young professionals, musicians and athletes, who are all mingling, sharing information and learning about problems or diseases they may never have experienced but that plague large parts of the world.

Thomas Hansen, the CEO of Seattle Children's Hospital, enthusiastically explained a low cost mechanical ventilator for children in poor countries to a crowd of young party guests.

"We're really at the tipping point," said Todd Leadens, 22, an intern at at Boeing and engineering student at the Rochester Institute of Technology. "We have the technology to understand the problems and we can do something."

Seattle is also benefiting from the experience of people like Sanna Nyassi, who survived two bouts of malaria growing up in The Gambia, and went on to play professional soccer.

In a lab room at Seattle BioMed, Nyassi sat patiently on a stool while a woman named Diane powdered his face.

"Sanna, I'm not going to tell your teammates about this makeup situation," said Kevin Griffin, director of fan development & community relations for the Sounders FC and Seahawks.

"At least it's not eyeliner," said Diane.

"They save that for Freddie Ljungberg," Griffin quipped, not missing a beat.

"Do you have something to wipe that off later?" Griffin asked the makeup artist.

MARK HARRISON/SEATTLE TIMES

Sanna Nyassi is stepping into the limelight to call attention to malaria.

Nyassi, the soft spoken 21-year-old Sounders FC midfielder, was about to make his debut in front of the camera as a spokesman in a public service announcement for the non-profit. He had just met researcher Stefan Kappe, the man who is leading work on a malaria vaccine, and taken a look at the parasite under his microscope.

Two film crews followed his tour through the building.
"Could you look straight into the camera?" the producer coached Nyassi. "Could you say 'Now that's a great goal?'" The filming seemed tedious but Nyassi didn't complain.

"I can do this again and again," he said. "I feel good my club is part of this."

Libuse Binder, who wrote a book called "Ten Ways to Change the World in Your Twenties," summed up what attracted her to Seattle and why she thinks what's happening here matters.

"There's a surge of educated, intelligent tech-savvy people who want to make a difference and know how to do it," she said. "We can spread the word really quickly and start a movement."

"I think because we have so much access we know what's a stake. We're concerned. We're the ones inheriting the world."

In the face of the ongoing environmental disaster in the Gulf of Mexico, the U.S. Senate must pass a clean energy and climate change bill now.

That urgent call today came not from the usual environmental advocates but from business leaders who see their economic landscape eroding along with the melting glaciers without some immediate action.

WIN MCNAMEE/GETTY IMAGES

Contract workers from BP ferry contaminated waste from the Deepwater Horizon disaster while other workers use skimmers to clean oil from a marsh in Louisiana. This map helps to visualize the size of the disaster if it were here in Puget Sound.

Weyerhaeuser, Nike and other companies from around the Northwest joined Olympia-based non-profit Climate Solutions in urging the Senate to act. They spoke on a conference call with journalists this morning.

Unveiled last month in the Senate, the American Power Act aims to cut greenhouse gases, reduce oil imports and create millions of new energy-related jobs.

Climate Solutions' Ross Macfarlane said the bill has the backing of hundreds of Northwest companies for a variety of reasons, including increasing American competitiveness, creating a stable and predictable environment for investments, protecting national security and minimizing the damage that businesses are seeing in natural resources.

While the bill isn't perfect, the most important element is "a strong and escalating price signal on global warming pollution and carbon dioxide," Macfarlane said.

He also cited recent polls in Oregon and Washington that show public support for clean energy and climate legislation. Washington voters supported legislation by a 13 point margin, while Oregon voters supported it by an 18 point margin, according to surveys done in late May by Public Policy Polling.

The $730 billion U.S. outdoor recreation industry, which includes companies such as REI, Timberland, The North Face and Patagonia, supports 1 in 20 jobs, said Amy Roberts, vice president of government affairs at the Outdoor Industry Association. A warming climate is taking a toll on the ecosystem and the economy, she said, and among the effects is a decline in snow packs, which shortens ski seasons.

Clay Young, co-founder and CEO of Inovus Solar in Boise, said developing new energy technology is a huge opportunity, but he sees this country falling behind. The U.S. is facing strong competition from Chinese companies because of investments and incentives China is making in clean energy.

"We are more and more looking at sourcing energy technology outside the U.S.," he said. "I see our leadership in this sector as waning not gaining."

Changes to energy policy, with a focus on taxing carbon, are needed to stimulate innovation from the private sector, Young said.

Denny Gignoux owns and operates Glacier Wilderness Guides at Glacier National Park in Montana. As the park celebrates its 100th anniversary, the number of glaciers there has dwindled from 150 to 25, he said.

"We're looking at the loss of one of our main attractions," he said. "Where is it going to be for our children and grandchildren?"

Arlo Skari, a Montana farmer, said rising temperatures have brought more flies and insect damage to the state's wheat varieties. As snow melts earlier, spring runoff depletes water supplies, leaving shortages in late summer.

For Nike, its typical consumers are young, active and concerned about climate change, and will be more impacted by it than generations before, said Sarah Severn, director of stakeholder mobilization for Nike.

The company's global supply chain relies on cotton production, which is vulnerable to changing weather patterns, she said.

For Weyerhaeuser, a national policy on carbon emissions makes more sense than state by state legislation, said Sara Kendall, vice president for environment, health, safety and sustainability. The company is looking at ways to turn plant fibers into cellulosic biofuels. "Good policy will allow us to accelerate these investments," Kendall said.

Convincing Northwest businesses to get behind the legislation may be a lot easier than bringing coal companies, automakers or other heavy industrial manufacturers on board.

Ultimately a lot more is at stake than the bottom line.

"Without leadership from the U.S.," said Severn, "the rest of the world will have difficulty coming together" on a climate change agreement.

Benefit concerts tend to be one-time events, but a Seattle group wants to use performances in a new way to unite music and philanthropy.

MARIANGELA ABEO

Ryan Abeo, a.k.a. Ra Scion of the local hip hop duo Common Market, has a new solo project named for superhero Victor Shade and will perform in the inaugural Gigs4Good show.

Team Up for Nonprofits aims to support Seattle philanthropy by producing "Gigs4Good," a series of concerts, each one benefiting a different non-profit. Producer Ryan Hodgson and a group of friends and colleagues started Team Up last year with the goal of giving people of any age a chance to meet and network with like-minded people, enjoy performances and contribute to a meaningful cause for the cost of a concert ticket.

Team Up for Nonprofits will kick off its fund raising efforts tonight with a concert at the Hard Rock Cafe that will benefit Seattle Against Slavery (SAS), a grassroots group working to fight human trafficking. Tickets are $25 at the door.

Ryan Abeo (Ra Scion) along with Alexei Saba Mohajerjasbi (Sabzi) formed Common Market, a duo that describes its music as "a critical, unapologetic world view that change is not only necessary, it is inevitable, and can only come about through having love for and serving the people."

Tonight Ra Scion headlines as Victor Shade, along with DJ B-Mello, Project Lionheart, Sol and Dice.

Next month, another interesting benefit concert will feature Starbucks General Counsel Paula Boggs, who is also a singer and songwriter, celebrating her debut CD "A Buddha State of Mind." She's donating all proceeds from the June 26 concert at EMP Sky Church to radio station KEXP.

Ten years ago a group of Northwest volunteers sent their first container of bicycles to Ghana. Now the Village Bicycle Project is preparing to send its 100th container, having delivered 45,000 bikes and 15,000 tools and trained more than 7,000 people how to use them.

The program was started in Ghana after the country removed import duties on bicycles in the mid-90s. The goal is to improve lives of people in rural areas who would otherwise have to walk hours each day.

MARY JAYNE CASSIDY

Women in Ghana learn to ride used bikes donated through the all-volunteer Village Bicycle Project.

The group collects donated bikes from all over the world, but many of its core supporters are in Seattle, including Bike Works. On Saturday, the all-volunteer organization will be loading its next container in the Georgetown neighborhood of Seattle and is looking for help to collect bikes, take them apart and pack the container.

Village Bicycle Project pays for the cost of shipping by selling bikes that are in good condition through two partners in Accra, said board member Meg Watson. Those partners set aside one-third of the bikes for the training programs in villages and sell the rest wholesale from their storefront shop.

Once bikes are trucked to villages, free training classes are held to maintain and repair bicycles. People who participate the training can then purchase one of the bikes for about $20, half the normal price, Watson said.

"Selling bikes is part of a development model that prevents bikes being horded by the powerful, and makes them more available to those who can best use it to improve their economic circumstances," she said.

The project works with Peace Corps volunteers, who host its programs, and has reached about 60 communities throughout Ghana. It also holds advanced repair workshops to train people to set up small repair businesses.

The next step is increasing the number of women in the program and expanding to Sierra Leone, Watson said. About 30 percent of the participants are women. In Sierra Leone, where volunteer Brittany Richardson recently taught 500 school girls how to ride bikes.

"The people of Sierra Leone were begging for bikes from Brittany, so we are sure an eager market awaits us," Watson said.

Guidelines for how to donate bikes can be found here.

The ARAS Foundation of Sammamish has collected more than 2,500 bikes for the project and has a bicycle drop-off event on May 15. For more information: www.villagebicycleproject.org

Organizations in Seattle are advancing research into emerging and neglected diseases, but what about neglected threats to public health?

The University of Washington aims to take the lead in shedding light on a fundamental issue for the field of global health -- war.

This week UW will tackle that theme as host of the 8th Annual Western Regional International Health Conference, beginning Friday, which blends academic work with a social change mission.

Beyond direct military casualties, the conference will look at indirect impacts on health, which cause more deaths and illnesses than many major diseases.

Co-sponsored by Physicians for Social Responsibility, the conference will define preventing war and reducing violence as an emerging area of study and practice for people in the global health field, how students and professionals can promote peace, and how to develop new global health leaders who are focused on that goal.

Speakers include Chris Hedges, author of "War is a Force That Gives Us Meaning;"
Alfred McCoy, author of "A Question of Torture;" and Janet Johnson Bryant, the Liberian journalist featured in the film "Pray the Devil Back to Hell."·

Kavita Ramdas, CEO of the Global Fund for Women, has been speaking out on the issue of war and its relationship to health.

At a global philanthropy conference in Seattle recently, Ramdas singled out violence as one of the biggest barriers to women's advancement, a new hurdle beyond the traditional issues of poverty, lack of economic opportunity and access to education.

"What has changed in the last 10 years," she said, "is the additional barrier of growing militarization of their society, the increased presence of arms and weapons in almost every part of every person's life."

The world has seen a surge in conflict and violence in all corners, she said, from ongoing civil strife in the Democratic Republic of Congo to crime on the south side of Chicago.

The effect has been "stunningly high levels of violence against women all over the globe, she said. "The scale of this violence is an epidemic."

Part of the problem is that resources in the U.S. and elsewhere that were once used for education, health and domestic infrastructure have been diverted to military budgets, Ramdas said.

Somewhat related to that is an interesting study about the effects on African-American women of the high incarceration rates of black men.

Jacqueline Koch, a Seattle-based writer, photographer and native French speaker, is senior communications officer for the non-profit Merlin USA, an international medical relief organization. Since 2005, she has documented and reported on Merlin health programs and medical emergency response in Sri Lanka, Indonesia, Myanmar and Kenya. She is now in Haiti, where she wrote this post describing the health situation in a rural village a few months after the Jan. 12 earthquake.

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We're headed to Petit Goave, a town 70 kilometers west of Port-au-Prince, to meet a team of health workers operating a mobile clinic for eight rural villages. I pass Leogane on the way, where some of the earthquake's greatest damage is on display: 80 percent of the buildings are destroyed or damaged, reduced to piles of dusty cement blocks and mortar.

The streets are busy, filled with vendors and the to-and-fro of the local public transport called "tap tap." Like poppies growing along a stretch of asphalt, local crews in bright red and blue UNDP (United Nations Development Program) t-shirts line the side of the road, removing debris with brooms and shovels. A sign of promise amidst the grey, gritty rubble.

MERLIN/JACQUELINE KOCH

An elderly woman washes clothes in a plastic tub, gathering water from a leaking pipe at the church behind her, damaged in the earthquake.

The coordination of the mobile clinics is done out of a small hotel room. The team--one French project coordinator, one British country health director and the Haitian health staff of two doctors and four nurses--camp on hotel grounds in tents.

From my tent, I can smell the sea, but I have yet to see it. We are busy packing and organizing medicines and supplies to leave at 7:30 a.m., while the day is still cool. In a three-car convoy we trade the commercial hustle of Petit Goave for the quiet foothills overlooking the tranquil waters of Étang Miragoane.

On a rocky track, better fit for the increasing number of donkeys I see, people carry jerry cans of water past decidedly smaller homes. The local version of wattle and daub gives them a gingerbread-house quality. Some are painted pink and white, others green and red. Outdoor kitchens dot the yards defended by strutting roosters. We still have another hour and a half to go, but we have already reached rural Haiti.

MERLIN/JACQUELINE KOCH

Patients seeking health care at Merlin's weekly mobile clinic in Arnoux. About 200 people arrived and 160 patients were seen over the course of the day.

We arrive at Arnoux, a village of 10,000 people likely to be isolated again by landslides or floods when the rainy season hits. It has suffered minor earthquake damage but is definitely feeling the impact. More than 1,000 displaced people from urban areas have returned to this community, living on very thin margins.

"We have many health problems because of the lack of food," Val Dieux-Sauveur, the health agent for a local farmers' group, explains. "If you announced you were giving away free food, everyone from the village would turn up."

Arnoux's "main square" is a dusty lot for the few cars that survive the treacherous journey here. It is anchored by the health clinic (dispensary), a building that has lost its purpose. There is no electricity, no running water, no staff. Dieux-Saveur tells me that once a government nurse visited regularly to see patients here. But six months ago, he stopped coming. He found a paying position abroad.

MERLIN/JACQUELINE KOCH

Drs. Antoine Bruneau and Carolle Alexandra Steriling examine Rosena Felix, 14. Haiti has a very young population--40 percent are under 14 years of age.

Mothers, children and elderly people walk several hours to get basic health care or to a hospital if serious illness strikes-- if they can afford to go. Many cannot. So they live with chronic ailments that might seem simple, but without diagnosis or treatment can become life-threatening. Many kids here have scabies. Should bites get infected, they can abscess, developing into deadly septicemia. A feverish child might have the flu, or it could be the onset of malaria. Plasmodium falciparum, commonly known as "cerebral malaria," is the most common strain here.

We set up a nurses' station, a doctors' consultation room, an area for the dressings nurse and a pharmacy outside. Among the 200 or more people that turn up over the course of the day, most are dressed as if they are going to church for Easter Sunday. Girls parade in fluffy pink dresses, toddlers march around in shiny patent leather Mary Janes, mothers cradling their infants have donned colorful hats and brightly colored bead necklaces.

"You can tell it's a big deal to them," said our Haitian translator Augusta Paul, who used to manage a Wendy's in New Jersey. "They don't often get to see a doctor, so it's a special occasion. They want to dress for it."

A quiet girl stands out from the crowd of patients. Rosena Felix, 14, is tiny for her age. Weak and clearly malnourished, she also complains of severe migraines that make her vomit and unable to keep any food down. Her symptoms puzzle the doctors, who become completely perplexed when she faints during her consultation and seems to have a small seizure. The medical team refers her to Notre Dame Hospital in Petit Goave. Supported by medical aid organizations, doctors there can assess her condition, order tests and provide the necessary treatment.

We transport Rosena and her mother, Roselaine. She lost her husband in the quake and put her three other children, including a nursing baby, in the care of a neighbor during her absence. When we get to the hospital and coordinate Rosena's admission to the pediatric ward, I notice the girl has changed her clothes. She traded a red t-shirt and shorts for an empire-waist dress, brown with colorful circles on it, tied back with a sash. She too has dressed for the occasion: meeting a doctor who might help put an end to the painful migraines that are robbing her of her health.

The next day, country health director Lizzy Berryman, who is also a nurse, visits Rosena and gives me an update "They've run tests and done an X-ray," she reports. "They found that she had suffered a skull fracture in the recent past, most likely the cause of her symptoms." Rosena will be put on a nutritional plan, given anti-convulsants, and then monitored weekly by the mobile clinic to see if she responds to the medication and gains weight.

Lizzy says she feels hopeful that Rosena's health will soon be back on track. And all it took was an X-ray.

If you're curious about microcredit, tomorrow evening looks like a good opportunity to learn more about it from an interesting mix of speakers, in one of the first such forums to be held in Snohomish County.

While government aid and grants from large foundations goes into programs to relieve poverty, a growing channel of unofficial support comes from individuals in Puget Sound, who are contributing small donations and even investments from retirement funds into pools of money that reach individuals all over the world in the form of small loans.

A free public Microcredit Forum -- with Global Partnerships CEO Rick Beckett, Fabric of Life Foundation Founder Carol Schillios and U.S. Representative Rick Larsen is planned to discuss how microcredit works as a solution to poverty.

DEAN RUTZ/SEATTLE TIMES

Carol Schillios, owner of the Fabric of Life store in downtown Edmonds.

Several local non-profits engaged in microfinance, which includes credit, savings, insurance and other financial tools, have announced partnerships recently with commercial banks and technology companies. Locally Washington CASH has seen a surge of interest in its training programs and small loans for entrepreneurs since the recession.

Seattle nonprofit Unitus signed a deal with the Overseas Private Investment Corporation (OPIC), and Citi to set up a $15 million credit facility for microfinance institutions (MFIs) -- the local partners that actually loan funds to borrowers.

The money will go toward helping institutions that aren't big or established enough to attract commercial capital to grow and provide more loans.

The Grameen Foundation, which has a Technology Center in Seattle, received $1.23 million from the MasterCard Foundation and $500,000 from the Cisco Foundation to expand an open source software platform designed specifically for microfinance institutions. That software, called Mifos, was developed in Seattle to help providers of microcredit automate their loan operations.

The grants will help institutions using Mifos connect to mobile payment systems and track progress.

Vittana, a Seattle non-profit that applies the concept of micro lending to student loans, reached important milestones this month -- people lending $25 or $50 at a time through Vittana made more than $150,000 in loans to nearly 200 students around the world. A group from online real estate company Redfin, for example, has loaned $893 to six students in Paraguay.

Created by two former Amazon.com employees, Vittana helps fill a niche that for all its success, microcredit had not addressed. Micro loans typically go to people operating small businesses, but loans for college had no such source of funding. Some students have already landed jobs and started to repay the loans, said CEO Kushal Chakrabarti.

Jacqueline Koch, a Seattle-based writer, photographer and native French speaker, is senior communications officer for the non-profit Merlin USA, an international medical relief organization. Since 2005, she has documented and reported on Merlin health programs and medical emergency response in Sri Lanka, Indonesia, Myanmar and Kenya. She is now in Haiti, where she wrote this post describing efforts to rebuild from the perspective of a local field hospital.

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Each day, we are 12 people cramming into a little minibus that leaves the office/housing base located at Delmas 83 on the edge of Port-au-Prince. Departure time is 7:15 am, an early start to avoid getting stuck in the city's infamous and stultifying traffic. I've joined the medical and surgical team who've come to treat emergency trauma patients, injured in Haiti's January 12 earthquake. They are working at a field hospital that opened January 20 and was established on abandoned tennis courts.

We make our way through a dusty urban landscape radically redefined by the earthquake's seismic spasms. The landmarks of our daily journey to the hospital reflect the scale of disaster and the start-and-stop pace of recovery: a four story building flattened to resemble a stack of plates; a neighborhood blanketed in the flimsy patchwork of blue and white plastic tarps, and a side street housing a colony of tents, baking under the hot tropical sun.

JACQUELINE KOCH

A large chunk of concrete tore away much of the tissue from Claudine Souffrant's wrist. The 15-year-old needed specialized treatment at Merlin's surgical field hospital, including a skin graft to try to restore function to her hand.

Now two and a half months since the earthquake, the dissonance between the utter destruction and the push toward rebuilding a stronger Haiti leaves me overwhelmed at the enormity of the task ahead.

Red spray paint announces a call for help alongside the new address for thousands of homeless people: "S.O.S. Refugee Camp Delmas 40-B." Yet on the same sidewalk, street vendors are spearheading a rebound in the economy. At a brisk pace they sell burgundy red sugar cane sticks, fried bananas, button-down shirts, and an expansive collection of oil paintings. The paintings are perhaps the most ironic among the goods for sale, illustrating scenes of a serene, pastoral and verdant Haiti. There's no hint of the nation's spiral to the near-bottom of the Human Development Index. There's no evidence of the 1.2 million people who are now out of their homes, struggling to cope with the lack of clean water, food, and shelter--or the new misery the approaching rainy season will bring.

When we get to the field hospital, the medical team fans out to various ward tents for morning rounds. The facility is fully equipped with one operating theater--housing two tables allowing the team to operate on up to two people at a time-- four ward tents with beds for 40 in-patients, and a separate area for out-patient treatment services providing basic health care for as many as 300 people a day.

The specialized surgical team, an orthopedic and plastic surgeon, have the combined skills to better treat the grave but common injuries that result from earthquake disasters: complex bone fractures, severe crush injuries and extensive tissue loss. Each of these injuries can lead to secondary, life-threatening infections, so the aim is to save lives and limbs. It's a nascent approach for medical emergency response sector, but has clearly led to better outcomes. With restored function and mobility in their limbs or hands, patients will have a better quality of life once they fully recover.

JACQUELINE KOCH

Emmanuel Etienne, 21, lost his right leg in the earthquake. His family lives about three hours from Port-au-Prince, but he's staying in the capital to await a prosthetic and physical rehabilitation from Merlin and Handicap International.

While trying to avoid unnecessary amputations, the surgical team is also working with a number of amputees who need ongoing follow-up care so their wounds can heal properly and in such a way that it works well with a prosthetic limb. Upon opening, the Delmas 33 field hospital filled rapidly with patients transferred from city hospitals that were damaged, overwhelmed and under-resourced. Many patients had already undergone amputation surgeries under extreme emergency conditions, as did the mother of one of our staff. Trapped in the rubble and unable to get out, her husband was forced to cut off her leg with a machete to save her life. She is just one of thousands of people who were teetering between life and death in the immediate aftermath of the earthquake. While Haiti's government estimates that there are 4,000 new amputees in this country, other organizations working here put it higher.

At the field hospital, we have amputee patients ranging in age from 2 years old to 52 years old. Emmanuel Etienne, 21, was transferred after he lost his right leg just below the knee. Plastic surgeons have performed a skin graft to make sure the wound closes and heals nicely in order to fit well into a prosthetic leg. Emmanuel understands that having prosthesis will be key to living something closer to a normal life without his right leg.

"I just got into high school (secondary school) and I have two more years to go before I can go onto university," he said, adding that he'd like to study medicine. But he worries that the earthquake tragedy has stolen these hopes.

We've been working closely with partner organizations to help each patient rebuild their lives amidst great uncertainty. For each patient like Emmanuel, there is a considerable coordination effort to ensure they have a plan for follow-up treatment, physical therapy, rehabilitation and the prosthetic limb they need. In Haiti, already the poorest country in the Western Hemisphere and grappling with high unemployment, young men like Emmanuel will be vulnerable in the scramble for a job and resources.

The Bill & Melinda Gates Foundation is boosting its investments in the health of mothers and newborns, which saves lives at a much lower cost than treating diseases later on, Melinda Gates said. The world's largest private foundation is also stepping up its efforts to fund contraception, she said.

At a time when effects of the recession are straining budgets worldwide, Gates urged governments to maintain their commitments to global health and pointed out how donors can "get more bang for your buck."

Gates, who is co-chair of the foundation, spoke on a call Monday evening with members of the organization ONE along with Melanne Verveer, the U.S. Ambassador-at-Large for Global Women's Issues.

ERIC FEFERBERG/AFP/GETTY IMAGES

Melinda Gates visits a hospital in Benin with French First Lady Carla Bruni-Sarkozy and AIDS World Fund Director Michel Kazatchkine in January.

Promoting breast feeding for the first six months of life, for example, boosts a child's immunity and reduces exposure to disease, Gates said.

"To do that costs about $2 to $7 dollars to save a life, versus tens or even hundreds of dollars per life to treat something like malaria and AIDS," she said.

"I'm not saying we shouldn't do malaria and AIDS, but I'm trying to point out how inexpensive it is to save these newborn lives."

The emphasis on maternal health is interesting in the context of a study and editorial by the medical journal The Lancet last year, which cited an "alarmingly poor correlation between the [Gates] Foundation's funding and childhood disease priorities," saying specific diseases like malaria and HIV dominated the foundation's focus.

The amount the Gates Foundation gave to maternal, newborn and child health increased from about $46 million in 2008 to more than $128 million last year, according to a grant search on the foundation's Web site. Last year the foundation also gave $16.5 million for family planning. Its funding for malaria reached nearly $350 million.

Gates talked about teaching a method known as "Kangaroo Mother Care," which encourages mothers to wrap and hold their babies until they can maintain their own body temperature. (In fact a study published this week found that "kangaroo mother care" cut newborn deaths by more than 50 percent and was more effective than incubators). Inexpensive drugs can also prevent mothers from hemorrhaging in childbirth.

Such a comprehensive program, together with contraception, could cut maternal deaths by 75 percent and reduce newborn deaths by 44 percent, she said. More than half a million women a year die in childbirth, and 4 million babies die in their first month of life, according to the World Health Organization.

Gates said she often gets asked "Aren't these moms going to overpopulate the world?" but in fact the opposite is true. "When moms know their babies are going to live into adulthood, they naturally bring down their population. And they're thrilled because they have the chance to feed two or three children versus five or six or seven."

Women also need access to contraception, she said.

In a visit to Malawi earlier this year, "I was pretty blown away with how many women were asking for family planning" but don't have it, she said. "They are clamoring for modern science."

From its beginnings as a tiny lab in Issaquah with a staff of five, the Seattle Biomedical Research Institute has grown to more than 300 people and is about to test one of the world's first vaccines for malaria on a group of volunteers.

"It's stunning to me we have been able to come so far so quickly," said Ken Stuart, who founded the private lab in 1976 as Seattle's first global health organization and now heads the largest independent non-profit dedicated to infectious disease research. (The non-profit known as SBRI is now officially acronym-free after re-branding itself Seattle BioMed.)

KEN LAMBERT/SEATTLE TIMES

Malaria researcher Stefan Kappe stands in the "warm room" where mosquitoes are raised in the lab at the Seattle Biomedical Research Institute.

Advances have come in "small, imperceptible steps," he said, addressing a crowd of more than 500 at the annual Passport to Global Health event last night.

Now the institute is about to embark on a big one. In a few months, volunteers will be bitten by mosquitoes carrying a cloned strain of malaria to test a malaria vaccine candidate developed by Seattle BioMed researcher Stefan Kappe.

The malaria project started in 2000 and now is the sole focus of 100 scientists, Kappe said. The German native who studied at Notre Dame and taught at New York University said he came to Seattle in 2003 with a dream to succeed where others had failed.

A $50,000 grant from private donations helped him sort infected liver cells, and $32.5 million in funding from the Gates Foundation helped him take the concept from mice to humans.

His approach to the vaccine is using genetic engineering to remove two key genes and make the malaria parasites harmless. The first part of the human trials is a safety phase to make sure the vaccine doesn't make anyone sick. The next part involves infecting the vaccinated group with malaria later this year. The trial, to be held at the Walter Reed Army Institute of Research, involves 26 people. Results will be announced in early 2011.

Later the team will need to test the vaccine in Africa and identify strains that protect for the longest time at the lowest dose, Kappe said.

In the future, inside its South Lake Union building, Seattle BioMed will be able to use its own newly built Malaria Clinical Trials Center (MCTC), one of four facilities in the world that can test new malaria treatments and vaccines in humans. More than 300 people in the Seattle area have already signed up as volunteers for trials of malaria drugs and vaccines, which could begin later this spring or summer.

Tuberculosis, a contagious airborne disease that is increasingly resistant to drugs, infects about a third of the world's population and kills nearly two million people a year.

In some areas, one in four people with tuberculosis has a form of the disease that no longer responds to standard drugs, according to a new report by the World Health Organization. WHO estimated that 440,000 people had multidrug-resistant TB in 2008 and a third of them died.

With global travel and migration, "TB anywhere is TB everywhere," said Peter Small, the senior program officer for TB at the Bill & Melinda Gates Foundation, who manages an annual grant budget of $120 million. He said the disease is at a critical tipping point, where new tools to diagnose and fight it are being developed, but co-infection with HIV is fueling an epidemic and drug resistant TB poses an unprecedented global threat. Below is an edited Q&A.

Q: In what parts of the world is TB most concentrated?

The highest rates of TB are in sub-Saharan Africa, where there's a convergence of TB and HIV. The highest number of cases are in China and India. That's where the largest number of drug resistant cases are.

In China and India, it's largely because of the size and density of the countries. It's also a consequence of the loosely controlled use of antibiotics. You can literally buy them over the counter.

A couple of years ago there was a great deal of attention over an attorney with drug resistant TB who flew across the ocean. That story sort of put a human face to the fact that with modern population movement and migration, TB may be [more prevalent] in some areas, but that doesn't mean it's not an issue for everyone.

Q: What work is being done in Seattle?

Seattle is a critical node in the global fight against the antiquated technologies we're using -- a 125-year old diagnostic test and an 80-year old vaccine. There are now rapid DNA-based tests that can tell you within hours, not weeks, with certainty that a person has TB. The test I am thinking of is about $25, but there is a whole pipeline of tests coming in the next five years or so that are cheaper and easier to use. For Seattle we are making huge progress in making better tools to fight TB. (Organizations involved include Seattle Biomedical Research Institute, Infectious Disease Research Institute, the University of Washington and the Institute for Systems Biology).

We've made tremendous progress using a simple approach. Now we have these critical new challenges but innovation coming on line that can put TB control into the next gear. There are six TB vaccines now in human trials, we have nine drug molecules which are in human trials and already available to be mixed and matched to get best the treatments and at least a dozen diagnostic tests.

Q: Have you had TB yourself?

When TB is in a family, only about a third of the people get infected, and why is it that? Do they have different immune systems or did they inhale at the wrong time? I absolutely have no idea, and to be perfectly honest I'm not even convinced that I'm not infected with TB. The test is imperfect and I've spent a significant amount of time in the presence of infectious TB cases. It speaks to the thin veneer of understanding upon which our response to TB is based.

The focus is on identifying and treating those who have symptoms -- those who are infectious to others.

Q: Can you explain the differences in the types of TB that are emerging and treatments?

Standard TB is cured 95 percent of the time with $20 worth of antibiotics. Multidrug-resistant TB (MDR-TB) is a bacteria resistant to those antibiotics, Treatment still can likely be achieved with a 75 percent cure rate. But now it takes 18 months of antibiotics, some of which are quite toxic, maybe on par with cancer treatment, and the cost is $5,000. But there are some cases, extensively drug-resistant TB (XDR-TB), which are resistant to all known antibiotics.

Q: Can someone catch TB on an airplane?

It's possible and statistically pretty unlikely, but the fact that it is possible and has happened is a reminder that public health is really about ensuring the health of the general public. It's not just about taking care of poor people; it's not a generosity issue.

If anyone has TB, that is a public health threat for everybody around them. So ensuring everyone in the U.S. who has TB is diagnosed and treated is a central public health challenge.
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On Wednesday evening, four health experts and a TB survivor will hold a public forum at the Olympic Sculpture Park Pavilion to discuss the worldwide epidemic as part of World TB Day. Details are here. In 2009 there were about 250 cases of TB reported in Washington state, more than half in King County.

Moving from the Bill & Melinda Gates Foundation to the head of a government agency with 8,000 employees in 82 countries is no small shift.

But Rajiv Shah is using his experience at the Gates Foundation to reshape the way America's development arm works, from narrowing the focus of its programs and emphasizing science and technology, to creating a new Global Health Initiative with specific goals to reduce deaths from preventable diseases.

DEAN RUTZ/SEATTLE TIMES

After working for the Gates Foundation in various roles for eight years, Rajiv Shah was sworn in as USAID administrator just five days before the earthquake struck Haiti.

Shah returned to Seattle from Washington D.C., where he is administrator of the U.S. Agency for International Development, to speak at the Life Science Innovation Northwest annual conference. He later stopped by the Times for an interview.

In January he arrived at an agency that had lost half of its staff and much of its clout over the past 15 years.

Development work had been shifted to private contractors or to the Department of Defense, and many of the best people left USAID, diminishing its "intellectual leadership," he said.

As the new USAID administrator, his job is to help turn that around. The Obama Administration has pledged to double foreign aid, and the agency is now hiring 400 foreign service officers a year, Shah said.

Shah said he will call on companies working in life sciences to focus some of their energy on global health. USAID is spending $63 billion over six years on a Global Health Initiative and is looking for solutions including:

--Vaccines for HIV, TB and malaria
--Longer lasting contraception and microbicides
--Simple diagnostic tools for TB and malaria
--Solutions for transferring health data from remote sites
--Technologies to eliminate the need for temperature control of vaccines

The Global Health Initiative's goals include:

--Reducing pregnancy-related deaths by 30 percent, saving the lives of 360,000 women
--Preventing three million child deaths a year
--Preventing one million deaths from tuberculosis
--Cutting malaria cases by half in sub-Saharan Africa

Five days after he was sworn in, a catastrophic earthquake struck Haiti, killing an estimated 230,000 people, and Shah was charged with coordinating the massive U.S. relief effort.

Haiti has become a testing ground for whether USAID can overcome challenges of a dysfunctional bureaucracy, and for the larger project of "rebranding America across the world."

Problems over food aid, procurement and trade policy have been some of the agency's biggest challenges.

Last week Haitian President Rene Preval said Haiti needs help with job creation and less donated food, which can undermine local producers.

Shah said USAID was able to source the first 6,500 metric tons of rice for emergency aid to Haiti from local producers.

"It just created a mindset that these are capable resilient communities and we need to respect and work with them," he said.

Building local capacity means giving more contracts to local NGOs, rather than requiring U.S. contractors to do the development work. Shah said contracts above $75 million are now subject to review to try to break them into smaller pieces, and distribute work locally.

In some poor countries, trade and aid work at cross purposes. In 2006 the U.S. gave $120 million in aid to Bangladesh and Cambodia and collected $853 million from them in import duties, according to a report by the Initiative for Global Development.

The model of wealthy countries sending money to poor ones is outdated, Shah said.

New global realities require partnerships with emerging countries such as China, India, Brazil and Russia. They are starting to play a role as donors and taking on development work in places like Africa. If Chinese can build roads and other infrastructure more cheaply, it's smarter for the U.S. to contribute something else, he said.

This year's Global Social Entrepreneurship Competition at the University of Washington had so many promising business plans that picking just two winners proved difficult. So judges did something unusual: they ponied up their own money on the spot to award another $3,000 prize.

The contest, which had 161 entries from 36 countries this year, combines business, non-profit and academic work to encourage creative solutions to global poverty.

The top winning team taking home $10,000 was Nuru Light -- Charles Ishimwe from Adventist University of Central Africa and Max Fraden of the University of Massachusetts Medical School -- who also won the GSEC People's Choice Award and Investor's Choice Award. The team created a clean and affordable alternative to kerosene as a light source in Rwanda. The portable, rechargeable lights are the size and shape of a tape measure and the charger is a portable box with a bicycle-style pedal.

The UW Global Health prize of $5,000 went to ToucHb, a non-invasive finger scanner that measures hemoglobin levels to diagnose anemia. It can be used by low-skilled village health workers in rural India and eliminates the fear and infection risks associated with a needle prick. The team is made up of two doctors from the Maharashtra University of Health Sciences -- Yogesh Patil and Abhishek Sen.

The spontaneous Judges' Choice award of $3,000 went to Malo Traders for their plan to help small-scale rice farmers in Mali earn a better living by providing storage, marketing and other post-harvest services. Team Malo is two brothers who grew up in Africa and are now studying in the U.S. -- Mohamed Ali Niang, a business student at Temple University, and Salif Romano Niang, PhD student in political science at Purdue.

On Friday, the projects were on display at a breakfast hosted by the Seattle International Foundation, where students with ideas talked to executives with funds and experience.

ToucHb got tested by PATH CEO Chris Elias, while Microsoft veterans Rob Short and Will Poole wanted details about Nuru Light's business plan. Check out the video above with winners introducing their projects.

World Vision is the world's largest Christian charity that works in some of the poorest and most politically unstable places on earth. It also educates and employs local women. All those factors make it a potential target for extremists.

But as our story today shows, attacks on aid groups in general have been on the rise, and in these regions of Pakistan, some are wondering whether the dangers might force them to close down operations.

MARY KATE MACISAAC/WORLD VISION

A mother in Afghanistan and her children spend hours each day shelling pistachio nuts. Eight kilograms net less than one dollar.

Mercy Corps, which works on health, education and small business development for women, in addition to emergency aid to displaced people, has four missing employees in northwest Pakistan. It suspects they have been kidnapped, an all too common danger for aid workers.

In parts of Pakistan and Afghanistan, aid organizations have had to hide women who participate in vocational training programs -- for their own safety -- because working outside the home could get them punished.

Two women were among the six killed and another two women were injured in the attack Tuesday on the office in Oghi, a remote town in Pakistan's North West Frontier Province. Although no group claimed responsibility, police suspected Taliban militants may be behind it since the town had been a major militant training center. All of the employees of the office, including those killed, were local Muslims.

The New York Times reported the assailants shouted at the aid workers that they had been "forewarned to stop spreading immodesty."

"Sadly there are elements within the area who view any form of social change, education or health programs associated with the outside world as a threat," said Sam Worthington, who heads InterAction, the largest coalition of U.S.-based international nongovernmental organizations.

But more evidence shows why it's important not to give up. Economic development, and especially empowering women and girls, may be one of the most successful tactics in the fight against terrorism. Sometimes the tribal leaders themselves request, and protect, schools.

If those programs do leave the area, Worthington said, so do the vital services that were never there before, including "the first access to a classroom for girls, the first chance to have children immunized against diseases, the first chance for mothers to have pre- and post-natal care."

A school that educates girls to become future leaders will celebrate its 10th anniversary by recognizing local women for their contributions to women's health and welfare.

Seattle Girls School is honoring UW Epidemiology Professor Laura Koutsky for her two decades of research that led to the world's first human papilloma virus (HPV) vaccine, which helps prevent cervical cancer. A great profile of Koutsky can be found here.

Students will also honor Nan Stoops, executive director of the Washington State Coalition Against Domestic Violence, for her work over the last 30 years as a trainer, organizer and advocate against violence. Both awards will be given out at a student-hosted lunch Tuesday at the Seattle Sheraton.

BENJAMIN BENSCHNEIDER/SEATTLE TIMES

Dr. Laura Koutsky is credited with developing the world's first human papillomavirus (HPV) vaccine along with Dr. Kathrin Jansen, a yeast expert at Merck Research.

On Wednesday, Melinda Gates is receiving a Global Trailblazer Award from U.S. Secretary of State Hillary Clinton at the Kennedy Center in Washington D.C. for her work promoting social justice.

In Seattle on Thursday, Catherine Bertini, the former director of the United Nations World Food Programme, will speak at RDI's annual International Women's Day lunch focusing on land rights.

A couple of years ago when Bertini first left the World Food Programme and became a senior fellow at the Gates Foundation, I asked her why food aid programs had not been more successful and I remember being surprised by her answer. She told me the main reason is that they had failed to adequately support the role of women in agriculture.

Women produce as much as 80 percent of the world's food, but they own less than 2 percent of the world's land, according to RDI.

Another local organization calling attention to women's rights is the Jolkona Foundation, which has a page dedicated to projects supporting women around the world.

Nothing says more about the challenges they still face than the title of one project: "Free and educate enslaved Nepali girls."

On the 100th anniversary of International Women's Day, writer Nicholas Kristof argues for three basic steps to improve lives of women: girls education, better diets and help starting small businesses.

JOHN LOK/SEATTLE TIMES

USA's Nicole Joraanstad, bottom, and teammate Natalie Nicholson, compete against Germany at a curling match during the Vancouver Winter Olympics.

VANCOUVER -- U.S. Olympic curler Nicole Joraanstad presented a $10,000 check to the Kent School District today, as one of five athletes supporting their hometowns through a partnership with Crest.

Joraanstad grew up in Kent and practiced at the Granite Curling Club, the only such club in Washington state. A 1999 graduate of Kentridge High School, she moved to Wisconsin when she was 18 to pursue curling. "I had a hunch it would get me in the Olympics someday," she said.

Joraanstad is co-captain of the U.S. Women's Curling Team and has a sponsorship deal with P&G, the maker of Crest toothpaste. The Kent district will receive the company's $10,000 donation for its health and physical education program.

It's one example of philanthropy happening at the Olympics, as athletes use their voices and resources to support various causes of their own and to help fellow athletes.

The gold medal for giving probably would go to snowboarder Hannah Teter, who is giving all of her prize and sponsorship money to charity, supporting work in Haiti, Kenya and Darfur.

After winning the gold medal in halfpipe at the Turin Olympics in 2006, she created a maple syrup called Hannah's Gold and has used proceeds to help fund charitable causes.

Teter has a partnership with the Christian charity World Vision, and has raised $185,000 so far for a project helping a community in Kenya with clean water and sanitation. About $130,000 of that comes from her contest winnings and another sizable chunk from Hannah's Gold.

Samsung, one of her sponsors, matches sales of her maple syrup dollar for dollar, and as part of its marketing deal gave $30,000 to her foundation last week.

Giving back is one of the main characteristics Samsung looks for in choosing athletes to sponsor, said Jose Cardona, communications manager for Samsung North America.

Teter also takes philanthropy where it's never gone before in "Panties with a Purpose." She created a line of underwear called Sweet Cheeks that gives $5 from every pair to a charitable cause -- this version helps Doctors Without Borders.

Scott Macartney, the ski racer and U.S. Ski Team member from Redmond I wrote about today in a story on sponsorships, has been supporting the World Cup Dreams Foundation, started by former team members Bryon Friedman and Erik Schlopy in 2005. The foundation gives members of the U.S. National Alpine Ski Team the chance to compete at the highest level by providing financial support and disability insurance coverage.

It makes sense that Macartney would choose to help others -- the two-time Olympian was raised by parents who volunteered in the ski patrol.

Several events are using the world's spotlight on the Vancouver Olympics to call attention to poverty and health issues.

I've written about the Poverty Olympics in the context of Vancouver's homelessness problem. Now there's the Condolympics, a contest to test knowledge about condoms in Kenya.

PATH/DANIEL OLUOCH MADIANG.

A Kenya Wildlife ranger competes with civilian colleague in condom blowing during the Condolympics, an event that aims to increase knowledge of condoms and reduce the spread of HIV/AIDS.

Led by Seattle-based global health non-profit PATH, the unorthodox project targets various civil servants, youth and police in Kenya.

According to PATH, the condom games are designed to encourage uniformed officers to "interact with the condom in an uninhibited forum while sharing condom knowledge and gaining usage skills."

The Elizabeth Glaser Pediatric AIDS Foundation is working with PATH on the project and participants include the Kenya Police, Administration Police, National Youth Service and the Kenya Wildlife Services.

PATH/DANIEL OLUOCH MADIANG

Police sergeants take a look at female condoms during the Condolympics, an event supported by Seattle-based PATH to reduce the spread of HIV.

Why focus on uniformed officers? They have a dangerous combination of risk factors: They're not using condoms consistently or properly, attitudes instilled in training make them feel invincible and immune to HIV infection, and work-related stress, peer pressure and loneliness lead to indulgence in casual sex, alcohol and drug abuse, according to PATH.

At the Seattle Asian Art Museum on a Saturday morning, traditional culture meets modern fitness -- a group of people splayed out on the marble floor practice yoga in a gallery surrounded by statues of Indian gods.

COURTESY OF RDI

Attorney Renee Giovarelli works to improve rights of women in Kyrgyzstan through the Rural Development Institute.

Later they gather inside the auditorium to hear Seattle attorney Renee Giovarelli describe the status of women's property rights in various parts of Asia, and its connection to hunger and poverty.

The scene represents the kind of engaging community salon that the "Saturday University" aims to create. Local universities, nonprofits and other institutions have deep expertise in Asia, but they don't always have a way to share it with the public.

"It should be a sense of pride for Seattle that those organizations are here," said former Seattle Art Museum director Mimi Gardner Gates, who conceived the series. Through the Gardner Center for Asian Art and Ideas, she hopes to introduce topics related to Asia, encourage community discussion and do it in a way that is fun.

GREG GILBERT/SEATTLE TIMES

Mimi Gardner Gates returns to her roots in Chinese art with a center focused on Asia at SAAM.

Continuing this month, the lectures explore "Health, Sex and Women's Rights in Contemporary Asia," accompanied by a series of films that were hits in their home countries but relatively unknown outside.

The series, "Guilty Pleasures," includes popular films from India, Japan, the Philippines and China. Each one is introduced by a film expert from the University of Washington.

Tomorrow speakers from the Gates Foundation and PATH will talk about Asia as a frontier in the battle for health equity. Each of the Saturday programs, which are co-sponsored by the World Affairs Council, starts with an optional yoga session by 8 Limbs Yoga.

In the spring, the Saturday University will explore the ways Asian religions are expressed in contemporary society, politics and the arts.

While the programs are held in the museum, the approach "appeals to people who aren't necessarily the art crowd," Gates said. "I love the idea of it being a center for people who are curious about Asia."

The Bill & Melinda Gates Foundation is stepping up the fight against tobacco with a $7 million grant to the American Cancer Society announced today. That follows a $10 million grant to the World Health Organization in December.

Both are aimed at curbing the tobacco industry's inroads in Africa, where cancer is emerging as a serious public health threat in addition to diseases such as malaria, AIDS and TB.

The $7 million, five-year grant to the American Cancer Society (ACS), which has taken on a more global role recently, will go toward managing a health coalition called the African Tobacco Control Consortium.

Consortium members include the ACS, Africa Tobacco Control Regional Initiative, Africa Tobacco Control Alliance, Framework Convention Alliance, Campaign for Tobacco-Free Kids and the International Union Against Tuberculosis and Lung Disease.

JENNIFER ROTENIZER/ASSOCIATED PRESS

Piles of what global health organizations don't want in Africa.

The consortium will work in 46 countries of sub-Saharan Africa to reduce tobacco use by
helping implement policies such as advertising bans, tobacco tax increases, graphic
warning labels and promoting smoke free environments, in line with the Framework Convention on Tobacco Control, the world's first public health treaty;

The World Health Organization started a new tobacco control effort in Africa with the help of a $10 million grant from the Gates Foundation late last year. Its goal is to prevent tobacco use from becoming as prevalent in Africa as it is in other parts of the world.

If tobacco use continues to grow at its current rate, it will kill more than 8 million people a year in 20 years, and more than 80 percent of them will be in developing countries, WHO predicts.

"Tobacco breeds poverty, killing people in their most productive years," said Dr. Ala Alwan, WHO assistant director-general for noncommunicable diseases and mental health. It consumes family and health-care budgets, and where resources are already scarce, "money spent on tobacco products is money not spent on such essentials as education, food and medicine."

For a detailed look at tobacco control in Africa, see Philippe Boucher's bilingual blog here.

I wrote about the Gates Foundation's challenges in fighting tobacco use in China here.

Seattle's Rural Development Institute received a $2.1 million donation, the largest gift it has ever received from an individual donor, for its work in rural China and in support of women's land rights.

The three-year grant came from a philanthropist based in Asia who wished to remain anonymous, said RDI President Tim Hanstad.

"Such a significant grant from an individual donor demonstrates the growing awareness of the value of secure, long-term land rights as an innovative solution to rural poverty," he said.

The money will allow RDI to continue field research, policy work and program implementation in China and will help expand RDI's new Global Center for Women's Land Rights.

RDI has worked in China since 1987 and now serves as a key adviser to the central government on rural land issues. RDI has helped advance legal rights of farmers, which has encouraged them to make long-term investments and helped them obtain better compensation if their land is used by the local government for development.

This story talks about RDI's efforts and history in more detail.

RDI Founder Roy Prosterman will speak and take questions about RDI's work in China and implications for the future on Feb. 10 at The National Bureau of Asian Research (NBR). More information about the event and background on the topic can be found here.

Martine Pierre-Louis hasn't been getting much sleep, and she suspects that other members of the Haitian diaspora are having the same problem.

She moved to the United States as a teenager 35 years ago but left a large extended family behind in Haiti. After the earthquake, her emotions traveled back in an instant to her loved ones and her childhood home.

"Literally we are traumatized thousands of miles away," she said.

She was fortunate that her family survived, but the immensity of the tragedy haunts her.

"What I keep saying to myself is that one lifetime is not going to be enough to grieve," she said. "I know that no matter when I die I'll still be grieving this."

Now director of interpreter services and community house calls at Harborview Medical Center, Pierre-Louis has been thinking about the about longer-term challenges of putting the country back together.

"The interest and energy and willingness to give that's present right now -- how can we harness that in the long run once all of the bodies have been cleared and all of the people who can be saved have been saved?"

People in Haiti have a kind of dignity that makes it difficult to accept so much outside help, she said.

ANGEL VALENTIN/GETTY IMAGES

Parishioners during Sunday Mass in Miami's Little Haiti pray in support of the earthquake victims.

"There's a sense of self that we feel, at least I feel, is lost. In everything that is going on there's a sense of loss that is so great we feel we're losing ourselves. It's a fear.

Pierre-Louis received an email from a Seattle friend who had moved to Haiti to do relief work before the disaster. She read the letter to me.

"Today we don't ask where do you live, it is more likely name of the street, or public place where you are sleeping. We don't say anymore so and so is dead; instead, so and so is lucky to be alive. I ran into a man who used to work for us. He lost nine members of his family, but he said he is lucky.

I met a couple who lost an 18 year-old daughter, yet open up their yard to the quake victims.
I have a co-worker who is still waiting for his wife to come back home from downtown. She went to run an errand and never made it back.
How can we ever be OK? But we must move ahead.
Haiti is a country made of people, and those who are still standing must do everything to continue."

Then she told me about a childhood friend who made it through the first earthquake unscathed and went in search of food for her family. She was struck in the leg by an object that fell in one of the many aftershocks, and her crushed leg was immediately amputated.

"People's nerves are frayed, and they are really, really traumatized," Pierre-Louis said. "There's great need for psychological support."

Pierre-Louis is working with a team in Seattle to prepare information and services to help survivors of psychological trauma, translating it into Creole and making it suitable for Haitian culture. She has been a Haitian Creole and French interpreter for over a decade, and is a founding member and past board member of the Society of Medical Interpreters and the National Council on Interpreting in Health Care. She also sings Haitian lullabies.

"Haiti will need all of the good energy and resources and time that donors can give," she said.

At Harborview she works with people from all over the world, "people who have experienced their own national tragedies," she said. Recently her colleagues have begun to share more about their own stories of living through war and disasters.

"I work with these colleagues daily, but for them to let me know that they also have had the experience of devastating loss and that is something we share. For me it's just one example of the amazing kindness I've experienced."

She's also been finding that there are more Haitians in the local community than she ever thought. "People are getting in touch with each other. The week of the earthquake, she got a call from a nurse who works in the King County tuberculosis clinic. She said 'I'm from Haiti. I'm a nurse. Can we talk?' When she came over she gave me a hug that lasted such a long time."

People like Pierre-Louis, who have medical expertise as well as an ability to bridge language and cultural gaps, will be needed more than ever before.

"What I would like to provide support with is in caring for the community I can care for right now -- the local Haitian American community," she said. Because in the future, she adds, "We will each be needed to step up in one way or another to serve Haiti."

By Hal Bernton

A Seattle couple who survived the Haitian earthquake and then worked to help treat the wounded will speak Sunday at Town Hall in a benefit for the relief effort.

SCOTT COHEN

Sarah Wilhelm and Jesse Hagopian.

Jesse Hagopian and his wife, Sarah Wilhelm, whose experiences splinting bones were chronicled in this Seattle Times article, will be joined by Rep. Jim McDermott, King County Councilmember Larry Gossett and other speakers in a forum that will run from 4 to 6 p.m. There will be a dinner break and then a benefit concert that begins at 7 p.m. at the Great Hall.

The suggested donation is $20, and the proceeds will go to Partners in Health and the International Training and Education Center for Health, a University of Washington-based organization that operates in Haiti.

A roundup of some of the other Haiti-related activities is here.

The $10 billion pledge for vaccines that Bill and Melinda Gates made today in Davos may be worth much more than that in the long run.

The couple announced that their foundation will commit $10 billion over the next decade for vaccines for the world's poorest countries. The world's largest private foundation is already spending more than half a billion dollars a year on vaccines, so this new commitment represents at least a doubling of its current efforts.

FABRICE COFFRINI/AFP/GETTY IMAGES

Gates Foundation co-chairs Bill and Melinda Gates get set for a press conference on vaccines at the World Economic Forum.

As seen in the past, the actions of the Gates Foundation tend to have a huge ripple effect on the world and effectively set the global agenda. Money from the Gates Foundation single-handedly revitalized research on malaria, which had largely been abandoned by the developing world.

The Gateses also helped make the battle against malaria a cause celebre by working with stars like Bono and others, an effort that has helped inspire scores of organizations that tap corporations and individual citizens for money to buy bed nets for African communities. Soon after the Gateses commitment to malaria studies, the U.S. government followed suit with a presidential initiative to distribute bed nets and anti-malarial drugs.

The flood of email to reporters this morning shows the Gates move was a highly coordinated campaign, involving organizations such as the World Health Organization, International Vaccine Access Center and GAVI (Global Alliance for Vaccines and Immunization).

"The Gates Foundation's commitment to vaccines is unprecedented, but needs to be matched by unprecedented action," said Dr Margaret Chan, WHO Director-General. "It's absolutely crucial that both governments and the private sector step up efforts to provide life-saving vaccines to children who need them most."

Julian Lob-Levyt, CEO of the GAVI Alliance, who accompanied the Gateses for the news announcement in Davos, said GAVI would not exist if not for Bill & Melinda. Now it gets funding from 17 nations, and the WHO estimates the expanded vaccinations have saved five million lives.

"The Gates Foundation cannot achieve the full promise of vaccines on its own," said Orin Levine, executive director of IVAC. "Manufacturers must increase their investments in vaccine research and development, donor countries must mobilize to help fund new vaccines, and developing countries must make the investments and take the steps necessary for delivering life-saving vaccines to their children."

Will this new high-profile pledge compel donor nations to allocate more of their budgets to vaccines (or risk being slammed in public forums before world media)? And if so, will that come at the expense of something else?

Results of a study on rotavirus vaccines yesterday pointed to a whole range of other factors critical for their success, including clean water, proper sanitation, oral rehydration therapies, breastfeeding and vitamin supplements. It also pointed out problems in the cold chain --- distributing vaccines to far the reaches of poor countries while trying to maintain them at a constant temperature to keep from spoiling.

In his annual letter, Gates warned that increased spending by governments on climate change could jeopardize funding for vaccines.

The new emphasis on vaccines is one indication of the influence Bill Gates has had on the foundation in his first year on the job full-time. Watching Gates interviewed by Jon Stewart on "The Daily Show," (granted the segment was only six minutes) it was striking that he mentioned just two things about the foundation's work outside of the U.S. -- vaccines and better seeds.

Local fund-raising events, volunteer drives, non-profit campaigns and other efforts to help Haiti continued this week.

Tonight Seattle Greendrinks, SeaMo, ReVision Labs and Global Washington will jointly host a benefit for Fonkoze, a microfinance and development organization in Haiti working on emergency relief and long term reconstruction. A suggested donation of $20 includes live music, 6 to 9 p.m. at the Pike Brewery. Details are here.

Fonkoze board member Melanie Howard, Charlene Balick of the Grameen Foundation and a volunteer recently returned from Haiti will talk about the current situation and ongoing relief efforts. The brewery is donating 25 percent of its receipts from food and drink to Fonkoze.

Seattle non-profit InterConnection is looking for donations of used laptops with Pentium 3 or Pentium 4 chips and accepting them by mail or drop off (shipping is free for donors). InterConnection is working with World Concern to get the equipment into schools, hospitals and NGOs in Haiti that have lost hard drives and laptops and have no resources to replace them.

ELSA/GETTY IMAGES

Wide receiver Pierre Garcon of the Indianapolis Colts celebrates with the Haitian flag after the Colts defeated the New York Jets.

The non-profit NetHope managed to bring Internet connections to NGOs working on the ground in Haiti this week through a long-distance WiFi network it set up in Port-au-Prince. Frank Schott, NetHope's global program director, operated a kind of command center from his home in Bellevue to coordinate efforts. NetHope is now providing Internet access through a shared hub to CARE, Save the Children, Concern and Catholic Relief Services, among others. The group is made up of 28 of the world's largest humanitarian organizations.

Brown Paper Tickets, a company based in Fremont that donates five percent of its profits to charities, added a microfinance partner in Haiti to its list of beneficiaries. Ticket buyers can direct part of the ticketing fee to one of three categories, and FINCA, which operates village banking in Haiti, will receive a portion of the proceeds.

The Mobile Giving Foundation announced that mobile donations have surpassed $33 million. The foundation has continued to add non-profits to its platform and now enables mobile phone users to send donations to 25 different organizations in the U.S. and Canada that are working on relief to Haiti.

Corporate donations surpassed $122 million two weeks after the earthquake, according to the U.S. Chamber of Commerce's Business Civic Leadership Center. About 300 companies have contributed to relief efforts, and 49 of them have donated $1 million or more.

Today the Chronicle of Philanthropy reported that more than $528 million has been raised in total for U.S.-based non-profits. Here's a list of relief groups and the amounts they've received.

Mercy Corps created a new way for people to raise money with personal fund-raising pages, designed by donors with personal messages and photos and used by schools, companies and other groups to give together. Mercy Corps said it has raised more than $500,000 from the pages so far.

It's a common virus that strikes young children in rich and poor countries alike, causing severe diarrhea and leading to more than half a million deaths a year.

Named for its wheel-like shape under a microscope, rotavirus causes vomiting and watery diarrhea, fever and abdominal pain.

Today health experts unveiled a study showing that rotavirus vaccines are an effective new tool to prevent deaths even in some of the poorest countries in the world and should be rolled out immediately where the virus is most severe.

"The widespread use of these vaccines has the potential to prevent about 2 million deaths over the next decade," Mathuram Santosham, professor of International Health and Pediatrics at Johns Hopkins University in Baltimore, wrote in an editorial accompanying the study in the New England Journal of Medicine.

Sponsored by a global partnership that included Seattle-based PATH, clinical trials showed that rotavirus vaccines reduced deaths among poor populations in Malawi and South Africa. However, the success rates varied significantly -- from 49 percent in Malawi to 77 percent in South Africa.

In 2006, Mexico was one of the first countries to introduce rotavirus vaccine. Last year, deaths of children age two and under from diarrheal disease dropped by more than 65 percent during the 2009 rotavirus season, PATH reported.

Experts recommended the vaccines be combined with other measures such as clean water, proper sanitation, oral rehydration therapies following bouts of diarrhea, breastfeeding, and vitamin A and zinc supplements. The availability of oral rehydration solutions in parts of Africa and South Asia is less than 35 percent.

The study also pointed out considerable challenges to distributing rotavirus vaccines in the poorest countries, including shipping and storing the vaccine at the proper temperature.

"The storage and shipment requirements to avert cold-chain breaks of rotavirus vaccines are far greater than those of typical childhood vaccines, which will make the logistics of vaccination programs in developing countries more difficult," Santosham wrote.

Making the vaccines available at a price affordable to poor countries is another challenge -- it requires some of the cost to be paid by GAVI (Global Alliance for Vaccines and Immunization), which relies largely on funding by national governments.

Coca-Cola is easily one of the most recognized brands in the world. Could linking some of the most impoverished people in Africa to the corporate giant's supply chain be a win-win for both?

The Gates Foundation is funding a project to help farmers in Kenya and Uganda produce fruit for Coca-Cola. Coca-Cola says the farmers can help it meet a critical need to increase production as global and local demand for fruit juice grows.

ELLEN CREAGER/MCCLATCHY NEWSPAPERS

The ubiquitous Coca-Cola brand reaches every corner of the world.

The $7.5 million Gates grant will go to TechnoServe, a U.S.-based nonprofit, to train mango and passion-fruit farmers to improve their quality and increase production, and to provide the farmers with credit.

TechnoServe works with large corporations like Coca-Cola, using a private sector approach to align corporate interests with those of small enterprises in developing countries, and increase profits for both.

The project aims to bring 50,000 farmers into Coca-Cola's supply chain for the first time and to double their incomes by 2014.

For some perspective on this new partnership, I asked Chris MacDonald, a business ethics expert who teaches at Saint Mary's University in Halifax, Canada and is a Senior Fellow at Duke University. He has written about Coca-Cola's work in developing countries, including this report on an African water project.

"This clearly seems like a positive thing, over all," he said in an email about the new Gates-funded partnership. But the way it's set up makes all the difference. "It would be best if these farmers are being brought into Coca Cola's supply chain in a way that doesn't leave them dependent on it," he said. "Being dependent on the purchasing whims of any particular company seems dangerous, maybe a mixed blessing."

I also checked the Business & Human Rights Resource Centre, which keeps track of the record of many companies, including Coca-Cola. The company has come under fire for its water use in India. Yet it has also taken steps to build or repair water infrastructure in African countries.

Coca-Cola said the partnership will also serve as a model for the way it approaches other developing country markets where it does business.The four-year, $11.5 million partnership includes a $3 million contribution by Coca-Cola and $1 million from its bottling partner Coca-Cola Sabco.

Including loans to farmers as part of the project also raises some questions. "Anything that requires farmers to go into debt is at least a little worrisome," MacDonald said. While debt can be useful for people expecting incomes to rise, "I hope those farmers are getting some good, impartial advice about their financial planning."

The Gates Foundation's longer term goals for African agricultural development are eradicating poverty and improving food security. With a company whose main product isn't healthy, "there's reason to be worried about the company extending its reach, and hence its market, into more and poorer countries," MacDonald said.

Initial relief turned to grief for Trilogy International Partners as it learned that five members of its wireless subsidiary in Haiti were killed in the earthquake or its aftermath.

The largest U.S. company in Haiti, Bellevue-based Trilogy provides mobile phone service through its Voilà subsidiary, which has about 575 employees.

Company executives initially thought the local workforce in Haiti had escaped without casualties. An inspection by its head of security following the earthquake found that all five of its buildings in Port-au-Prince remained intact, and the earthquake happened before the office closed for the day. Many employees returned to work Wednesday.

Yet a few days later Trilogy learned that five employees had died and about 35 others remain missing, said Carol Wilson, Trilogy's international compliance director.

Dozens of employees lost immediate family members and about 95 are without homes. The company's offices were filled with people camping out on the floor, Wilson said. The company is posting regular updates on the situation in Haiti here.

Trilogy engineers managed to get its network back up last Wednesday and it remains the only operational cellphone service in Port-au-Prince, but "the issue is congestion," Wilson said. Huge volumes of traffic are straining the network.

The company set up the non-profit Voilà Foundation to direct donations to relief efforts. Trilogy Chairman John Stanton and his wife, Theresa Gillespie, have pledged at least $1 million, and Trilogy International Partners has pledged $3 million.

A group of structural engineers flew from Seattle to Haiti today to go through the buildings to check further for structural damage.

Groups from soccer fans to music lovers and microfinance supporters are organizing events around Puget Sound to raise money for Haiti relief efforts.

On Thursday, Jan. 21, Casuelitas Caribbean Cafe in Belltown will serve Caribbean snacks and Haitian rum punch from 6-10 p.m. Proceeds go to to earthquake relief in Haiti through the Florida Association for Volunteer Action in the Caribbean and the Americas (FAVACA), a nonprofit helping people in the region for more than 25 years. Benefit includes sale of Haitian steel oil drums and a raffle. Details are here.

On Saturday, Jan. 23, Sounders FC fan club Gorilla FC will host a fund-raising event at the George & Dragon pub in Fremont with midfielder Steve Zakuani and defender James Riley as a benefit for Wyclef Jean's Yele Haiti Earthquake Fund. Details are here.

On Sunday, Jan. 24, Seattle restaurants are teaming up to hold a dine around Seattle event to raise money for NetHope and other relief organizations. More details are here.

On Thursday, Jan. 28, Seattle Greendrinks, SeaMo, ReVision Labs and Global Washington will jointly host a benefit for Fonkoze, a microfinance and development organization in Haiti working on emergency relief and long term reconstruction. Suggested donation of $20 includes live music, 6 to 9 p.m. at the Pike Brewery. Details are here.

On Thursday, Jan. 28, a benefit concert and auction called "Seattle Helping Haiti" will be held at the Moore Theater with proceeds going to the American Red Cross. Details are here.

I'll be updating this post as I learn of other events.

Do you have a story to share about Haiti? We're putting together a collection of first person accounts here.

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Previous events

On Monday, Jan. 18, the Nectar Lounge will host a benefit party, "Haiti We Stand," for Convoy of Hope.

On Tuesday, Jan. 19, Seattle-based World Concern and radio stations SPIRIT 105.3 and PRAISE 106.7 are holding a drive and looking for volunteers to take calls from the broadcast studios in Shoreline. Training will be provided. Contact Jacinta Tegman at World Concern (206) 546-7524 or jacintat@worldconcern.org

On Wednesday, Jan. 20, Re-Bar will present "One World: A Benefit for the Victims of the Earthquake in Haiti," to benefit the American Red Cross and Wyclef Jean's Yele Haiti. More details are here.

On Wednesday, Jan. 20, Lucid Live Jazz Lounge and other venues along University Avenue in the U District will hold a benefit with live music to support the efforts of Lucid owner David Pierre-Louis. With help from Seattle's jazz community, Pierre-Louis traveled to Haiti last Thursday to locate his mother in Port-au-Prince and bring emergency supplies. He's expected to be at the Seattle benefit to raise more funds for relief efforts. Details are here.

The U.S. Chamber of Commerce reported today that corporate donations to Haiti relief efforts have grown to $60 million. So far more than 120 companies have contributed to the cause, and 22 of them donated more than $1 million each.

Combined with record giving from individuals using social media and technology, and contributions by non-profits, help to Haiti is on track to be one of the largest relief efforts ever.

InterAction, the leading alliance of U.S. humanitarian and development groups, said today that organizations have committed and raised a combined total of $100 million to support the relief work.

Microsoft pledged at least $1.25 million in cash and in-kind donations to relief efforts in Haiti today as its disaster response team is reaching out to help relief agencies. Microsoft encouraged its 55,000 U.S. employees to make donations, which the company matches up to $12,000 per employee.

Akhtar Badshah, senior director of global community affairs, said Microsoft was also working through the organization NetHope, a network of large relief agencies and technology companies, supporting efforts to restore power and communications in Haiti.

So far, 1,600 Microsoft employees have contributed more than $280,000 to 100 non-profits working in Haiti, which are matched by the company.

California-based biotech Amgen, which has a research center with several hundred employees on Elliott Bay, said it will donate $2 million toward relief efforts. The Amgen Foundation will also use a disaster relief web site for staff around the globe to contribute funds to designated organizations, and the foundation will match them dollar for dollar.

"It is amazing to see how many companies have responded to the urgency of this tragedy," said Stephen Jordan, executive director of Business Civic Leadership Center at the U.S. Chamber. "We are encouraged by the early outpouring of support but we are well aware that this is going to be a marathon, not a sprint."

Other leading donors were:

--Digicel ($5 million) Digicel is the largest wireless service provider in Haiti (the other is Bellevue's Trilogy) and Digicel lost two of its employees in the earthquake.
--Trilogy International Partners ($3 million, plus $1 million from Chairman John Stanton and his wife, Theresa Gillespie).
--Deutsche Bank ($4 million)
--General Electric ($2.5 million)
--Citigroup ($2 million)
--Credit Agricole S.A. ($1.45 million)

The full list is here.

On Monday Starbucks announced a $1 million donation from The Starbucks Foundation to the American Red Cross for Haiti.

The non-profit Mobile Giving Foundation is now supporting text message donations for at least 17 different humanitarian organizations helping Haiti. Donations of $5 and $10 made by text message have now surpassed $20 million. A list of the organizations accepting mobile donations is here.

Eliminating the usual processing time for mobile donations, Verizon Wireless today said it transmitted almost $3 million to the American Red Cross for Haiti relief efforts, which represents the dollars pledged by its customers via text message donations so far.

Alaska Airlines and Horizon Air set up a program for frequent flier members to donate their miles to charitable groups involved in the relief effort in Haiti. Between now and Feb. 15, up to 5 million miles donated to the program will be matched one-for-one by the airlines.

The RealNetworks Foundation is donating $50,000 to Medical Teams International (MTI) for earthquake relief in Haiti. Nordstrom donated $50,000 to the American Red Cross Haiti Relief and Development Fund.

PCC Natural Markets (PCC) made a $25,000 donation to the American Red Cross.

The Hunger Site and GreaterGood.org sent $125,045 to Partners in Health today, a combination of online donations received through GreaterGood.org and contributions given by The Hunger Site and GreaterGood Network stores.

Amazon.com has a box on its homepage for contributions to Mercy Corps' Haiti relief efforts, which had helped channel close to $500,000 from customers by Friday afternoon. The Gap Foundation donated $150,000 and offered to match employee contributions, Best Buy contributed $100,000, Western Union $50,000 and Nike $25,000.

Bellevue-based wireless service company Trilogy International Partners, which operates in Haiti through its Voilà subsidiary, is providing the Mercy Corps team with a base of operations in Port-au-Prince.

In partnership with ITT, Mercy Corps will deploy five high-capacity water filtration units to provide much needed clean water in Haiti, and ITT is contributing a $100,000 donation, plus a double match for employee gifts.

Donations to U.S. groups' relief efforts in Haiti have reached $78 million and climbing, according to the Chronicle of Philanthropy.

For people thinking of contributing, here are a few resources with tips for safer and more effective giving.

Charity Navigator has put out a list of organizations working in Haiti, their history of work there, what they are providing and their charity rating. Clicking on the name of the organization provides details such as a financial report and how much the top executive is paid.

Another good resource is the Better Business Bureau's Wise Giving Alliance, which lists charities working in Haiti that meet its standards, and has a special section with advice on giving by text message.

In our region Philanthropy Northwest and Global Washington are both updating their Web sites with news about local donations and local organizations working in Haiti.

The FBI warned on Thursday that scam requests for donations are likely, reminding Internet users who receive appeals for money in the aftermath of Tuesday's earthquake in Haiti to apply a critical eye and do their homework. The FBI advised:

--Don't respond to unsolicited emails
--Be skeptical of anyone representing themselves as a survivor needing help through email or social networking
--Verify non-profits through independent Internet searching rather than following links
--Make contributions directly to known organizations
--Don't give out personal or financial information to anyone who solicits contributions

How did you choose which organization to support?

Wireless industry veteran John Stanton has worked all over the world and experienced the devastation of hurricanes and other crises at home and abroad. Nothing compares to Haiti, he said.

The earthquake hit a country already burdened with unreliable infrastructure, political instability, deforestation, poverty and homelessness.

"The tragedies there prior to Tuesday were so enormous that the notion that Haiti would be the country that would suffer this devastating earthquake, it's hard to believe," said Stanton. "It's just beyond imagination how many bad things have happened to Haiti."

Stanton is chairman of Trilogy International Partners, which provides a third of Haiti's phone connections through its wireless service Voilà. With 500 employees, Voilà is one of the largest employers in Haiti, and Trilogy the largest U.S. investor in the country, having worked there for a decade, Stanton said.

Trilogy was fortunate that its building did not collapse and its employees seem to have all survived, Stanton said. "An astonishing number of our people reported for work yesterday and this morning," he said.

CRIS BIERRENBACH /ASSOCIATED PRESS

A man uses a cell phone as he holds a person's hand after a 7.0-magnitude earthquake, the largest ever recorded in the area, rocked Haiti on Tuesday.

Trilogy CEO Brad Horwitz arrived in Haiti today to assess the situation and support the company's local staff. In addition, Trilogy operates in the Dominican Republic, so it has been able to send supplies over by land from the adjacent country.

Traditional landlines are almost non-existent, so wireless service is critical for both basic communications and emergency relief work. In fact, locals in Haiti said people who were trapped under debris have called out for help from their cellphones, the Associated Press reported.

"We are essential infrastructure on a normal day," Stanton said. "In times of crisis the most important thing is getting our system back on the air, which it is."

Wireless companies are constantly monitoring their service, so they were among the first to learn about the earthquake.

Within hours, Trilogy chartered a plane from Miami carrying 14 engineers, along with radios, batteries and water. They were able to land in Haiti early Wednesday morning with help from the U.S. State Department and Kenneth Merten, the American ambassador to Haiti. They knew that relief workers needed the wireless network running to do their jobs.

That's not easy in a country without a functioning electrical grid in normal times. All of Voilà's cellular towers run on diesel generators. The damage had knocked out a line between fuel tanks and generators. Getting trucks to deliver fuel and repair lines was a challenge across Haiti's damaged roads.

Though the service was down for much of Wednesday, local staff and the engineers from Florida worked feverishly to get it restored by midnight last night.

With growing demand from aid workers and people getting back in touch with loved ones, "the network is going to get swamped," Stanton said. The company was working to prioritize calls for rescue crews.

About 30 percent of the cell sites remained damaged, some simply out of fuel and others buried under tons of rubble, Stanton said. Crews worked to repair them, but the situation was still unpredictable. With aftershocks "a bridge there yesterday might not be there tomorrow," he said. "Our ability to keep the system up is obviously limited by our ability to get fuel to every site that depends on it."

Looking longer term, with Haiti's fragile foundation and the enormous challenges ahead, "there's almost an unlimited amount of things that have to be done," Stanton said.

Trilogy, which received an award from the U.S. State Department last month for making a positive impact on the Haitian economy, will continue working with the micro-enterprise it created to provide opportunities for local entrepreneurs and with its partner, musician Wyclef Jean's Yéle Haiti foundation, to improve education, Stanton said. Voilà is Yéle Haiti's largest corporate sponsor and has been since Yele launched in 2005 with a $1 million donation from the company.

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Mobile technology was proving important to Haiti in another way.

The earthquake has been "a watershed event," said Jim Manis, CEO of the Mobile Giving Foundation, a Bellevue non-profit which provides the platform for people to send donations by text message and pay for it on their monthly bill.

In the last 36 hours, more than $7 million was raised for earthquake relief through mobile donations, which "exceeded all money we've raised through mobile giving since we began" in 2007, he said.

The foundation is processing donations for a dozen charities helping Haiti, including International Medical Corps, the Clinton Foundation Haiti Relief Fund and Yéle Haiti, the foundation run by Wyclef Jean. Donations have come in at a furious pace.

At the peak, "we hit 10,000 messages per second last night," Manis said. Since processing the donations can take 90 days, Manis said he has been working with companies such as Verizon to push funds through faster. Carriers may decide to pay the donations as soon as customers pledge, rather than after billing, he said.

The Bill & Melinda Gates Foundation is making its first grant in response to the earthquake in Haiti -- $1 million to Catholic Relief Services (CRS) to aid its initial relief efforts, including immediate food, shelter, water, sanitation, health and other needs of people affected by Tuesday's earthquake.

UPDATE: On Friday, the foundation made a second grant -- $500,000 to Partners in Health (PIH) for immediate- and medium-term medical care through its existing 10 health facilities and temporary mobile clinics. The grant will also help pay for medical supplies, tents, blankets, water, and other essential items. Partners in Health has worked in Haiti for more than 20 years to bring medical care to poor communities.

CRS "has experienced personnel and a stock of emergency supplies in Haiti," the Gates Foundation said in a statement today. Catholic Relief Services personnel in Haiti were struggling to make sure that their 300 staff members are safe and accounted for, as well as beginning relief operations by preparing food supplies to be brought in Friday from the Dominican Republic. The CRS blog has some details about the situation on the ground.

"The humanitarian conditions are catastrophic, and much more will need to be done to address the immediate situation, as well as support the sustained recovery efforts in the weeks and months ahead so that people can rebuild their lives," the Gates Foundation statement said. "The foundation is continuing to monitor the situation and exploring additional opportunities to provide support for the relief efforts."

The largest private charitable foundation says it approaches emergency relief by trying to assist organizations that deliver food and clean water, improve sanitation, provide medical attention and shelter, and prevent or minimize outbreaks of disease.

It listed 10 relief groups actively working in Haiti for people looking for organizations to support.

The new face of U.S. foreign assistance stared into my living room from the TV screen, looking very familiar. There was Rajiv Shah, the former Gates Foundation agricultural development director, being interviewed by Jim Lehrer about Haiti.

Just when I was getting ready to write about how Shah must prepare to tackle things like streamlining bureaucracy, localizing programs and funding, and strengthening support for democratic governance (no pressure), along comes the biggest disaster in two centuries, striking an already fragile nation 700 miles from Miami. Now Shah, 36, is leading U.S. relief efforts just six days after being sworn into office.

COURTESY OF USAID

Rajiv Shah is sworn in as USAID Administrator as Secretary of State Hillary Clinton and Shah's family look on. Shah had supported her presidential campaign.

It's interesting to think that Shah was chosen to head the organization after the humanitarian physician Paul Farmer pulled out of the running last summer. Farmer, chairman of Harvard Medical School's Department of Global Health and Social Medicine, had dedicated so much of his life to improving health conditions in Haiti through Partners in Health that he would have seemed almost destined for that moment.

At Shah's swearing in ceremony, U.S. Secretary of State Hillary Clinton lauded his passion, vision and quiet humility, his degrees in medicine and business and experience with the Gates Foundation. "He brings determination and an unwavering belief that anything is possible," she said.

Shah, in turn, said that belief "was founded on our country's rich experience turning crisis into progress."

Shah talked about the necessity of reforming USAID to create stronger local systems in the countries it helps, staying focused on tracking progress and elevating the position of women and girls. Now more than ever the world has the ability -- and the technology -- to create massive improvements in the human condition, he said.

"We find ourselves in a unique moment of opportunity," he said. "A powerful consensus has formed that development is vital both to our national security and the shared interests of an interconnected world."

On TV tonight Shah looked like he hadn't slept in a long time. He talked about President Obama's commitment to focus U.S. efforts around saving lives in the first 72 hours after the quake, working with various branches of the federal government and in partnership with other countries to be as effective as possible. He projected a steady, smart and genuine presence.

Shah's first major test is also an opportunity for the country to show a struggling neighbor how it intends to redefine its role in the world.

It was clear the earthquake wrought devastation on a massive scale. Time saved meant lives saved. Two wireless companies in Bellevue went straight to work, one to repair its mobile network in Haiti and the other to channel funds to relief workers using text messaging.

In a country where traditional landline service is almost non-existent, more than a million Haitians rely on the mobile service Voilà for communications. That service is provided by Bellevue-based Trilogy International Partners, which received an award this year from the U.S. State Department for its decade of work in the impoverished country.

THONY BELIZAIRE/APF/GETTY IMAGES

Haitians carry injured in Port-au-Prince, as planeloads of rescuers and relief supplies headed there in a massive relief operation.

Trilogy said members of its crisis task force were one of the first aircraft to land this morning at the Port-au-Prince airport to assist on-the-ground efforts.The earthquake wiped out much of the infrastructure in the most densely populated part of the country. Its local team could travel only by foot because roads were so heavily damaged.

Senior management of Trilogy, its Haitian wireless operation (Voilà) and its Dominican Republic operation (Trilogy Dominicana/Viva) began a disaster recovery plan and formed a special task force to secure the safety of its 500 local employees and assess damages, the company said in a post today on its Web site. Within hours the team determined its buildings were intact and its staff located.

"Voilà's network continued to operate for several hours through the aftershocks before we were forced to shut down the switch to maintain its integrity until our generators and cooling systems were back online," the company said in its post. "We have restarted our generators at the main switch and are in the process of bringing our network back up. Once this has occurred, we will be focused on managing traffic and adding capacity as rapidly as possible to aid the humanitarian efforts in Haiti."

TRACIE MORRIS/BLOOMBERG NEWS

Trilogy Chairman John Stanton was given a global citizenship award from Secretary of State Hillary Clinton for his company's work in Haiti, including a micro-enterprise that helps local entrepreneurs earn money and a partnership with musician Wyclef Jean's Yele Haiti foundation to support education.

In Bellevue, Jim Manis at the Mobile Giving Foundation quickly worked to roll out text message- based fundraising efforts. Manis founded the non-profit to help other non-profit organizations receive donations through text messaging campaigns. I profiled the foundation here.

People can text a keyword to a designated short code and make a donation of $5 or $10 to any of several organizations working to help Haiti. Every penny of the donation goes to the charity, and the amount appears later as a charge on the donor's mobile phone bill.

The Mobile Giving Foundation said it has already raised about $375,000 today, through the following campaigns:

• Text the word "Yele" to 501501 to donate $5 to the Yele Foundation, the leading contributor to rebuilding Haiti founded by Wyclef Jean.


• Text the word "Haiti" to 25383 to donate $5 to the International Rescue Committee


• Text the word "Haiti" to 90999 to donate $10 to the American Red Cross.


• Text the word "Haiti" to 45678 (In Canada Only) to assist the Salvation Army in Canada.



Amazon.com established a box on its homepage today where customers can contribute to Mercy Corps' relief efforts.

Other groups engaged in ongoing relief efforts in Haiti include:

Partners In Health, Boston, www.pih.org
Mercy Corps, Portland, 800-852-2100 or www.mercycorps.org
Medical Teams International, Portland, 800-959-4325 or www.nwmedicalteams.org
American Red Cross, 800-733-2767 or www.redcross.org
World Concern, Seattle, 800-755-5022 or www.worldconcern.org
World Vision, Federal Way, 888-511-6548 or www.worldvision.org

Sam Dryden, an investor and entrepreneur, was named the Gates Foundation's new director of agricultural development today.

Dryden, a managing director of New York-based Wolfensohn & Company, an investment company, will begin the new post on Feb. 1. He replaces Dr. Rajiv Shah, who was sworn in Thursday as the administrator for USAID.

"Sam brings a wealth of experience to the foundation -- not only in agriculture, research and business, but also in a wide variety of projects related to agricultural development and public-private partnerships," said Sylvia Mathews Burwell, president of the foundation's Global Development Program. "His strong leadership qualities will help the team deliver on our strategy to help small farmers improve their lives."

In his new position, Dryden will lead a team attempting to help the world's poorest farming families boost productivity and incomes with better seeds, management training, access to markets and effective policies. The foundation, which has targeted agricultural improvements as one of its core missions, has committed $1.4 billion to agricultural development initiatives in Africa and South Asia.

Dryden has written and lectured widely on food security and economic development issues and served as an adviser on rural development for the World Bank and the Rockefeller Foundation.

At Wolfensohn, which was founded by former World Bank President James Wolfensohn, Dryden focused on investments in alternative energies. He formerly headed Emergent Genetics, which develops and markets seeds. Emergent Genetics, the third largest cotton seed company in the U.S., was acquired by Monsanto in 2005 in a $300 million deal.

The foundation's choice of Dryden raises a red flag for organizations that advocate against genetically modified crops, Bill Freese, science policy analyst for the Center on Food Safety, told the AP.

"Appointing someone like this as head of their agriculture project is a bad sign," Freese said.

Dryden has also been president and chief executive of Agrigenetics, a seed company now part of Dow AgroSciences, and was founder of Big Stone, a private venture and development company. His career began as an analyst with the U.S. Department of Commerce's Bureau of Economic Analysis.

Dryden has 25 years of experience as an investor and entrepreneur in the life sciences. He has served on a number of international boards and commissions focused on agriculture development, economic development and food security.

Two recent grants and a $10 million investment by the Gates Foundation aim to boost access to education and capital for African agriculture.

A $1 million grant today to Michigan State University will support a pilot project to create a virtual hub of agricultural education material.

The MSU researchers will work with African educators to develop material designed to improve agricultural practices in an 18-month project called AgShare Open Education Resources. The idea is to develop curriculum in the public domain to share freely among agricultural universities, NGOs and farmers around Africa.

DEBBIE DEVOE/CRS

Kenyan farmer Mildred Agola and her husband Patrick Karandi, left, greet partners in a Catholic Relief Services-led project to stem the spread of two diseases affecting the cassava plant. The project was funded by the Bill & Melinda Gates Foundation.

Michigan State University received a $10.4 million grant from the Gates Foundation last year to train African biosafety regulators on the latest advances in technology. Members of the African Biosafety Network of Expertise are taking classes and working with MSU faculty to learn about biotechnology issues affecting small farmers.

The Gates Foundation is also using newly designated funds for Program-Related Investing to make a $10 million investment in Root Capital, based in Cambridge, Mass.

Root Capital funds grassroots enterprises in developing countries, loaning to small businesses that often fall through the cracks between microcredit and commercial banks.

Root Capital said it will use the Gates funding to expand its operations in sub-Saharan Africa, providing access to credit, financial management training and global market opportunities to small and growing rural businesses. Root Capital also received a $4 million operating grant from the Gates Foundation to support a five-year growth plan to achieve a financially sustainable lending program by 2013.

Speaking of increasing agricultural knowledge, a local technology non-profit called Literacy Bridge has reported successful results from its own pilot program. Founded by Cliff Schmidt, a former U.S. Navy nuclear engineer, Literacy Bridge makes a $10 portable audio computer called the Talking Book. The device (pictured below) is designed to spread knowledge among populations with low literacy rates. It can be used to play and record hours of messages, and recordings can be shared from one book to another.

Working with agriculture, education and health officials in Ghana, Literacy Bridge produced content for Talking Books with such basic advice as when to start clearing farms, how to plant rows and when to start sowing beans.

Literacy Bridge delivered 21 Talking Books to a small village, to be managed by local leaders and shared by residents. After the first year, the program helped achieve a 73 percent increase in crop production and a $45,000 increase in crop value, the non-profit reported last month.

Ugandans could face the death penalty for being homosexual, according to a bill under consideration in the Ugandan parliament. The Anti-Homosexuality Bill can be traced back to remarks by several American evangelicals, as today's story details.

The bill has drawn worldwide outrage, and well known U.S. Christian leaders have condemned it as "un-Christian."

Seen from a global health perspective, the implications for addressing the HIV/AIDS pandemic are dire and could reverse the country's previous successes. The legislation would impose the death penalty for active homosexuals living with HIV.

Doctors treating HIV-positive gays could also be prosecuted for "aiding and abetting homosexuality," and some are clearly afraid.

World Vision, the Christian relief agency which has worked in Uganda since the mid-80s, said the legislation could undermine its work by stigmatizing people in communities it targets, according to Rudo Kwaramba, World Vision Uganda national director.

"Uganda is one of the first countries in which we started HIV education and prevention programs," Kwaramba said in a statement. "One of World Vision 's prevention models aims to reduce any stigma which may deter people from seeking to know their HIV status."

World Vision President Richard Stearns has been instrumental in getting more evangelical churches involved in addressing the HIV/AIDS pandemic. Such churches had been reluctant to help before because they regarded AIDS as a gay disease, or opposed condom distribution.

Kwaramba said World Vision is committed to working in Uganda regardless of whether the legislation is passed. However, to comply with the law, they could be forced to report homosexuals to the authorities.

The largest private international aid agency, World Vision has more than 500 staff members in the country.

As in other nations, "World Vision's work in Uganda is community-based and child-focused; the sexual orientation of those we serve, or those with whom we collaborate, does not arise," Kwaramba said.

Cassandra Nelson is no stranger to conflict and crisis, having worked for Mercy Corps in hot spots all over the world, including Afghanistan, Iraq, Gaza, Pakistan and Darfur.

But as she spent November in the Democratic Republic of the Congo, she was immediately struck by two things: how much violence is still raging there, and how rich the potential is if the country can move beyond it.

CASSANDRA NELSON/MERCY CORPS

Women in the Democratic Republic of the Congo build stoves out of clay for cooking more efficiently and reducing the use of firewood, which contributes to deforestation and is dangerous for the women traveling greater distances from camps to gather wood.

"It's a spectacular country," she said, "lush and mountainous and everywhere you look are flowers. One moment you see that vista, and then you turn your head the other direction and see some of the worst human suffering you've seen in your life... you just think how can this all be in one place?"

More than a decade of fighting has claimed at least 5 million lives and left more than a million people displaced, pushed into makeshift camps to seek refuge. The war has caused nearly seven times the number of deaths of the 1994 genocide in neighboring Rwanda, according to the Portland-based humanitarian group. The worst violence has been in eastern Congo, near Goma, the capital of Nord-Kivu province.

Recently "there's been a real perception that things have stabilized," Nelson said, but "the moment you leave Goma, things have not changed one bit. Every night there are gunfights and people getting killed."

Women and girls in eastern Congo have paid a terrible price.

Rape has become so common "it is almost a fact of life," Nelson said. "They're terrified of it but sometimes I get the sense they think it's unavoidable. It's happened to everyone."

As women go out to collect firewood for light, heat and cooking, they risk attacks by militia in the jungles and sometimes by government soldiers, too, she said. "Out in those woods there are a lot men with guns. It's either rape or it's harassment -- people stealing their wood or beating them."

The conflict has also taken a heavy toll on the environment. A recent UN study estimated that two thirds of the Congo Basin Forest will have disappeared within 30 years if the present rate of deforestation continues. Illegal logging and charcoal production remain a lucrative industry used to finance the ongoing conflict and buy guns for rebel militia groups, Nelson said. The strain on resources is even more severe as desperate people move into new areas and set up camps.

"First they're going out one kilometer and pretty much everyone has picked those," Nelson said. "In some places women go out 14 kilometers. People are literally spending half their day collecting wood."

CASSANDRA NELSON/MERCY CORPS

Congolese women make and store briquettes they created out of manure, which reduces deforestation and offers a safer alternative than searching for wood.

Mercy Corps is applying a practical solution to address both environmental destruction and women's security -- a fuel efficient stove.

The simple stoves can be made from sand, clay and brick found locally, and they consume less than half the wood of traditional cooking fires. That means women don't have to leave the relative safety of the camps as often.

About 30,000 stoves have been made through the Mercy Corps program and 10,000 distributed this year, Nelson said. Women are also learning to make briquettes from manure and other refuse, which burn more cleanly and are cheaper than charcoal. Besides saving trees, the stoves and briquettes provide a way to earn income for women who make and sell them.

So far Mercy Corps has trained 360 people to pass on the stove building knowledge to more women. "As they go home they take skills back and introduce this method to their villages," Nelson said.

The stoves have generated $160,000 worth of credits in the carbon market from the reduction in carbon emissions, she said. Mercy Corps uses the proceeds to teach women living in camps vocational skills, including animal husbandry, beekeeping and horticulture.

While the country continues to struggle with conflict and corruption, progress is measured in reducing danger and harm.

In the future, she said, "if the violence can ever be brought under control, it is a country with amazing natural resources and so much potential."

The Gates Foundation is getting some criticism from a local food co-op for supporting research into genetically modified crops to increase production in Africa.

PCC Natural Markets, the Seattle-based food co-operative, published a letter and editor's note this month taking a strong stance against genetic engineering of food.

"I caution the organic community to be watchful of this NEW Green Revolution, especially since The Gates Foundation science and technology efforts are led by a former Monsanto researcher,"
Dennis L. Weaver wrote in PCC's Sound Consumer.

"The Gates Foundation apparently is pushing genetically modified crops on African farmers," PCC editor Trudy Bialic added. She cited a $42 million Gates grant to a project involving Monsanto to produce corn resistant to drought "even though genetic engineering has failed to increase crop yields significantly, despite 20 years of research."

PCC, which has nine stores in the Puget Sound region and 47,000 members, is the largest consumer-owned natural food co-operative in the United States. Its staff writes a monthly report about issues in food safety and nutrition aimed at consumers.

Mark Suzman, director of policy and advocacy in the Gates Foundation's global development program, responded in a letter to PCC that the foundation is investing in a broad array of approaches and paying attention to environmental and economic sustainability.

"Most of our grants to improve seed quality use conventional breeding," Suzman wrote. "We include biotechnology when we believe there is potential to help farmers confront drought and disease, or to increase the nutritional content of food, faster or more effectively than conventional breeding alone."

The criticism by advocates of organic agriculture isn't new but illustrates a politically charged split over food, one that Bill Gates acknowledged in a speech in October at the World Food Prize symposium.

Gates said some critics are "instantly hostile to any emphasis on productivity," and that such an "ideological wedge" could thwart major breakthroughs to help farmers deal with the effects of climate change.

"The fact is, we need both productivity and sustainability -- and there is no reason we can't have both," he said.

But the local reaction reveals ongoing skepticism, even among an audience generally not at odds with Gates philanthropy.

"The organic community cannot buy into Bill's call to 'Let's just all hold hands, sing kumbaya, hug, air-kiss and "'get over" past "ideological" divides,' " Weaver wrote to PCC.

"I don't know exactly what is motivating the Gates Foundation to buy into the propaganda," Bialic said. "I think it's an ideology that technology can save the world."

As we await news of what world leaders manage to agree on, if much of anything, in Copenhagen, it's worth taking a look at one organization in Seattle that is training environmental leaders around the globe.

COURTESY OF EARTHCORPS

Roshani Rai of Nepal cuts a log for use on a trail structure in Seattle's Colman Park.

EarthCorps has been around since 1993, but it has taken some time for its efforts to gain traction. That's starting to happen as its 750 alumni disperse and apply their skills to new projects, from an international volunteer program at Lake Baikal in Russia, to a "zero waste" recycling enterprise in India.

The non-profit has brought environmental leaders from more than 60 countries to work on projects in the Puget Sound area. Half of its members are from around the U.S. and half are from countries in the developing world, and they share knowledge and expertise.

Besides the main group of about 50 members, EarthCorps now has 11,000 volunteers in Puget Sound, executive director Steve Dubiel told me. The level of interest has jumped this year, with three to four times as many people coming to activities aimed at local environmental restoration. Its teams have worked to improve 100 parks and green spaces in the region.

About 75 percent of EarthCorps' budget comes from fees it collects for its environmental services, so it has a more sustainable model than nonprofits that rely on donations or endowments alone.

COURTESY OF EARTHCORPS

Roshani Rai of Nepal plants native trees and shrubs along the shoreline of Burien's Seahurst Park. The planting followed a seawall removal project and is an example of Puget Sound shoreline restoration.

One EarthCorps alumnus went home to create a program in India that cleans up the streets and helps marginalized people by employing them to collect, sort and recycle 200 different kinds of garbage. Nothing, not even waste, goes to waste.

EarthCorps also emphasizes training women as future leaders.

"We put chainsaws in the hands of women who aren't used to having power," Dubiel said. "It's life changing."

When he joined the organization 15 years ago, Dubiel said, "I don't think people knew what environmental restoration was. I would say 'invasive plant' and people would give me a strange look. Now tons of people are out doing this work."

One of its projects has been removing ivy from Seward Park, where the group has cleared the plant from 42 of 50 acres of the park's forests.

If problems seem overwhelming, it can be satisfying to "just start somewhere," he said. "Stop talking, pick up a shovel and do something."

EarthCorps members working in far worse circumstances inspire others to persevere.

One EarthCorps member is fighting against the odds to preserve a freshwater dolphin in an area of Pakistan where the Taliban is waging war.

"You could have a more lucrative career," Dubiel said, "but don't we owe it to them to do the best we can?"

For another look at how Washington D.C. can learn from Washington state's approach to environmental solutions, see this post.

Like a rider through a treacherous mountain pass, Greg Mortenson negotiates through seemingly impossible obstacles to find safe passage for his schools in Pakistan and Afghanistan, choosing hope over fear and calling his only real enemy "ignorance."

Mortenson visited Seattle Tuesday and Redmond this morning to talk about his new book, "Stones into Schools: Promoting Peace with Books, Not Bombs, in Afghanistan and Pakistan." I spoke with him by phone on Tuesday while he awaited his flight from Portland. The Pacific Northwest is his biggest support network, where his champions hail from public libraries and book clubs to military bases and places of worship. His group Pennies for Peace carries on the work at home through programs for youth, teaching them about the world and how their philanthropy can make a difference. People in the Snohomish School District held a district-wide drive and raised more than $50,000.

The mountain climber and humanitarian founded the nonprofit Central Asia Institute, which has created 131 schools with the goal of advancing girls' education in rural Afghanistan and Pakistan.

COURTESY OF GREG MORTENSON

Greg Mortenson (third from right in back) with tribal chiefs from Urozgan province in southern Afghanistan, a Taliban stronghold where his institute established the first girls high school.

In "Three Cups of Tea," he writes about building schools for girls in the rugged mountains of Pakistan, while his new book focuses on neighboring Afghanistan.

Mortenson, 51, gives the mountains of remote Afghanistan the motto of his native Montana, "The last best place." There he found "a combination of courage, tenacity, hospitality, and grace that leaves me in awe," he writes. Such places often "represent the best of who we are and the finest standard of what we are meant to become."

I asked him how he manages to maintain his safety, let alone build girls schools, in Taliban strongholds:

TARA BISHOP

Author Greg Mortenson, son Khyber and daughter Amira in Gultori war refugee girls' school in Pakistan.

Establishing trust with local leaders is key, he said. "The Pashto word menawatay means the right of refuge. It means you will protect a guest with your life. Your honor in the tribal group is measured on your ability to provide hospitality for your guest. We have to take a lot of precautions, but my kids and wife do go to several places in Pakistan and Afghanistan."

(He was kidnapped and held for eight days in Pakistan in 1996.)

"Primarily we've tried very hard to work with the elders and we've put them in charge. The communities run the schools. When I am passing between two different feuding clans we'll sit there in the middle of nowhere and wait, and a military commander, a commandant, will send his emissaries. We'll have cup of tea and they will pass me off."

"It's absolutely imperative we build relationships..." As Mortenson's voice trailed off, he said he would call right back after passing through airport security in Portland. It took a lot longer than he thought. The U.S. Army veteran, whose advice has been praised by military commanders such as Admiral Mike Mullen and General David Petraeus, was detained again.

"Every time I come back into the country it's really difficult," he said later. "My passport is somehow marked. They ask me where I've been. I have to go into a special room. I don't look forward to coming back here for that reason."

Why choose to work in the remote Wakhan Corridor in Afghanistan?

"Our mission is to promote and set up schools, especially for girls, in areas where there is not education, generally in areas of physical isolation, religious extremism, conflict and war or natural disaster. Wakhan is the most remote. I think what really drew me there 10 years ago in 1999 a dozen Kirghiz horseman came over. They traveled six days a week, 16 hours a day on horseback. They were sent by their tribal leader to ask me to build a school in their region, the most isolated area in Afghanistan. You need to go in a jeep four days over rugged mountain and another three to four days by horseback over precipitous trails."

Why is girls' education the answer?

"Educating girls at least to a fifth grade level reduces infant mortality, and where I work about one out of three children dies before the age of 1. It reduces the population explosion. I think of all the problems in the world today -- we have global warming and wars -- I think there's just too many people on the planet. The number one way to reduce people is female literacy.

What I have seen is people coming home from the bazaar and they have vegetables or meat wrapped in newspaper. You'll see the mother very carefully unfolding a newspaper and asking her daughter to read the news to her. It's very empowering for a woman in an isolated area to read the news.

When mothers have an education they are less likely to encourage their sons to get into terrorism or violence. The Taliban's primary recruiting grounds are illiterate and impoverished societies. Most educated women refuse to allow their sons to join the Taliban."

On Afghanistan today:

"In the year 2000 there were 800,000 mostly boys in school, a Unicef figure. Today there are 8.4 million children in school including 2.5 million females. This is the greatest increase in school enrollment in any country in modern history. This is something few Americans are aware of.

Unfortunately the bad news is in the last three years in Afghanistan, the Taliban have bombed, burned or destroyed over 1,000 schools, and 850 schools in Pakistan. Ninety percent of the schools are girls schools. I think the reason they are bombing girls schools is because their greatest fear is not a bullet. It's a pen."

TERU KUWAYAMA

A school in a remote part of Afghanistan created by the Montana-based non-profit Central Asia Institute.

On what he teaches in the schools:

There are 131 schools now, plus another five dozen tent schools in refugee camps, serving 58,000 students (most of them girls): "Reading, writing, arithmetic, social studies. Elders come in twice a week and do storytelling to children...also hygiene, sanitation and nutrition. Since there's no health care, we teach teachers how to screen for vitamin deficiency, polio. We teach five languages by fifth grade, including Arabic and English, Dari in Afghanistan and Urdu in Pakistan and Pashto, and they also speak their tribal tongue. We are required by both countries to teach Islamiat studies, two to three hours a week studying the Koran and Islam. We teach kids to read and understand Arabic -- that's the difference between [our schools] and extremist madrasas. They teach how to read Arabic but not understand it. When you understand the Koran, there's nothing that says girls can't go to school. The two worst sins one can commit are killing someone and committing suicide. The real enemy anywhere is ignorance."

Does he still get threats here?

"I still get hate mail. I get threats. I've had threats all over the country. Our house was smashed by supremacists. People don't like the fact that I'm helping Muslims out. [Other] people don't like that I'm talking to the military. My wife says if people on the extreme right and extreme left don't like you, then you're doing the right thing. Americans are really great people. We're compassionate and courageous. There's too much emphasis on fighting terrorism, based on fear. If we promote peace, it's based on hope."

Did you manage to hear Mortenson's talk last night or read his books? Please share your thoughts.

You've heard of blood diamonds. Now mobile phones and other technology products are being targeted for containing minerals sold by armed groups engaged in war and rape in the Democratic Republic of Congo.

A House bill introduced today by Rep. Jim McDermott (D-WA) aims to curb that trade by identifying which mines are in conflict zones and requiring importers of related mineral goods to certify whether or not their imports contain minerals from those mines. Companies would have two years to implement the requirements, and the U.S. Trade Representative would report on their compliance.

McDermott said the conflict in eastern Congo is the deadliest since World War II and is fueled in a large part by the multi-million dollar trade in minerals. Armed groups generate an estimated $144 million each year by trading ores used to produce tin, tantalum, tungsten, and gold, he said.

Co-sponsored by Rep. Frank Wolf (R-VA), the Conflict Minerals Trade Act (attached here) requires companies to use outside auditors to determine whether refiners are "conflict-free." The USTR will report to Congress and the public which companies are importing goods containing conflict minerals.

In a report last December, the United Nations Group of Experts on the Democratic Republic of the Congo found armed groups in the eastern region continue to fight over, illegally plunder, and profit from the trade of columbite-tantalite (coltan), cassiterite, wolframite, and gold. Such groups enslave child soldiers and use rape as a weapon.

Minerals from the DRC are used in industrial and tech products worldwide, including mobile phones, laptops and digital video recorders.

Companies and consumers have the ability to make an impact. But enforcement of such a law seems tricky. A couple of questions come to mind immediately -- will companies really be able to identify sources of their supplies that clearly? Even if they can, two years is a long time in an entrenched and brutal conflict that claims lives daily. And what about China (the world's largest market for mobile phones) and its hunger for resources with a no-strings-attached policy for dealing in Africa? This report identified European firms fueling conflict minerals.

The bill has the support of the Information Technology Industry Council and the Enough Project, a Washington D.C. group working to end genocide and crimes against humanity in Africa. I wrote a bit about local efforts here.

Enough Project co-founder John Prendergast said he expects a legislative battle. "The electronics industry has spent about 2 million dollars per month lobbying to relax similar, yet weaker, legislation in the Senate (S. 891)," he writes. He urged consumers to push for passage of the bill. "Together we can help turn a system of exploitation and violence into one of peace and opportunity."

U.S. legislation would be a good start to address the problem, said Rory Anderson, deputy director for advocacy and government relations for Federal Way-based World Vision, which works in eastern DRC and endorsed McDermott's bill.

"Americans deserve to know whether the electronics they buy are fueling bloodshed in Africa," she said, adding that the law would benefit the electronics and software industries by providing a certified mechanism to label their products "conflict free."

"We saw from the success of our 'conflict diamond' campaign a few years ago that American companies want to do the right thing," she said, but "without a uniform process, such as the one proposed in this legislation, it's very difficult for companies to tackle the supply chain challenge on their own."

By Sandi Doughton

Fear is as infectious as any virus, and gives many Americans a warped view of the dangers posed by vaccines, genetically engineered crops and other beneficial technologies, New Yorker writer Michael Specter said in Seattle Tuesday.

Touting his new book "Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens our Lives," Specter took aim at the kind of anti-science sentiment he says is hijacking public discourse and policy.

JOHN MACDOUGALL/AFP/GETTY IMAGES

Ice sculptures by Brazilian artist Nele Azevedo melt on the steps of Berlin's Concert Hall in a WWF event aimed at calling attention to the earth's melting poles. Specter's book on denialism has been criticized for not tackling the issue of global warming.

"We need to step back and look at the other side of every issue - and we never do," Specter said at a lecture at the University of Washington sponsored by the World Affairs Council.

He was particularly critical of parents, like many who live on Vashon Island, who refuse to vaccinate their children. "This is insane," he said. "Vaccines are the most effective public health measure in the history of the world, except for clean water."

Study after study has shown no evidence that vaccines cause autism, yet people ignore a mountain of data and instead focus on unproven horror stories from neighbors or things they read on the Web, he said. "People jump to conclusions. They decide what makes sense to them intuitively."

While vaccination rates climb in the developing world, they are dropping in the United States and Western Europe - endangering more than the families who chose not to give their kids the shots, Specter said. Last year, children in Minnesota died of haemophilus influenzae for the first time since a vaccine was introduced 18 years ago.

Specter has written for The New Yorker about Bill Gates and his technologically-oriented crusade to improve global health. He's also covered the quest to develop synthetic life-forms, the AIDS epidemic and computer hackers.

Specter's Seattle audience was receptive to his pro-science message, but others have accused him of uncritically accepting arguments in favor of genetically engineered crops. See Tom Philpott's take in Grist.

The same review in Grist also took Specter to task for failing to grapple with the growing numbers of Americans who reject the overwhelming scientific evidence for global warming.

But Specter said he intentionally left that out because it's already been extensively covered.

Seattle's global health experts are busy in laboratories and in the field, working on problems such as HIV/AIDS and malaria. So busy, in fact, that they don't always know about work being done down the street.

Washington's health expertise is spreading around the globe.

A new study being unveiled today attempts to bridge the information gap. It shows the breadth and depth of the state's role in global health, mapping out nearly 500 projects of global health organizations in Washington in 92 countries with 587 unique partners.

The two maps are based on data from nine local organizations and will be expanded in the future to include others.

This map shows where local organizations currently have projects.

This map shows where Seattle organizations have offices and labs.

Produced by the Washington Global Health Alliance, the maps are designed to help local organizations discover potential collaborations and shared facilities, and showcase global health as a powerful and emerging sector in the region.

"Everybody recognizes that to address these issues, the more information the better and the fewer barriers the better," said Lisa Cohen, founding director of the alliance.

Alliance members include Fred Hutchinson Cancer Research Center, Institute for Systems Biology, PATH, Public Health - Seattle & King County, Seattle Biomedical Research Institute, Seattle Children's Hospital Global Alliance for the Prevention of Prematurity and Stillbirth, the University of Washington, Washington State University and the Bill & Melinda Gates Foundation.

The Gates Foundation is not included in the tally because the study focuses on organizations doing work in the field, not those funding them.

Many of the founding members of the alliance have doubled in size over the past five to seven years. Global health organizations expanding in South Lake Union are redefining the area beyond the original life-sciences cluster.

The alliance can help state businesses and non-profits get connected to opportunities in places where global health projects have paved the way, such as China and India, Cohen said.

Through the alliance, local health authorities hope to apply methods used in global health projects to improve health of people here in the Seattle area.

"A lot of people think global health is over there and doesn't have relevance here," Cohen said, but the H1N1 pandemic has made the links clear.

Community health workers, for example, have been vital to programs internationally, bringing medicine and information about prenatal care and disease prevention to people in rural areas. Such a model could work here, especially in South King County, where workers with language and cultural skills could help train diverse populations living below the poverty line who are unfamiliar with the health system, Cohen said.

The Obama administration has found yet another job for Rajiv Shah, the former Gates Foundation executive who has spent the past five months at the U.S. Department of Agriculture.

DEAN RUTZ/SEATTLE TIMES

Shah, 36, has been nominated to head the U.S. Agency for International Development (USAID), according to reports quoting unnamed U.S. officials.

Shah was running the Gates Foundation's agriculture development program when he was tapped for the agricultural post as Under Secretary for Research, Education, and Economics, as well as chief scientist, at the USDA.

Shah holds degrees in medicine and economics. A health care policy adviser on Al Gore's presidential campaign, Shah joined the Gates Foundation in 2001 where he worked as policy analyst and senior economist and developed an innovative program for vaccine financing. He served as director of strategic opportunities and deputy director of policy and finance for the global health program. While in Seattle, Shah served on the boards of the Seattle Public Library and the Seattle Community College District.

Meanwhile the top job at America's foreign assistance program has gone vacant for nine months at a time when the program and the Foreign Assistance Act need serious revamping, development experts say. The USAID's international affairs budget request for 2009 was close to $40 billion.

The Gates Foundation has shown its growing clout in the capital with Bill Gates among Obama's first visitors to the White House, influencing education policy, and Bill and Melinda Gates recently appearing before policy makers in Washington D.C., calling on them to maintain the U.S. commitment to foreign aid and global health funding.

Why Shah? It helps that he has already gone through the official vetting process, which has put off other candidates.

Senators John Kerry, chairman of the Senate Foreign Relations Committee, and Dick Lugar, the committee's top Republican, last month urged Obama to speed things up, saying that efforts to support the president's development agenda were being "hampered by a leadership vacuum" at USAID.

Amina S. Ali, African Union ambassador to the United States, made her first visit to Seattle this week, seeking to build bridges with Washington state institutions, which she says are playing a more important role in African business and development.

Ali, who is from Tanzania, represents an organization of 53 countries formed in 2002 and loosely based on the European Union, with the goal of helping integrate the continent to give it a stronger voice in the global economy while also addressing social, economic and political issues. The AU launched its first diplomatic mission in the U.S. in 2007.

Ali is the second high-level diplomat to come through Seattle in a week to meet the Gates Foundation, with a message to focus more on improving maternal health. Both Ali and U.N. Secretary General Ban Ki-moon warned that the world's goal of improving the health of mothers and children is falling further behind.

The African Union is calling attention to the issue in a new campaign to reduce deaths of women in pregnancy and childbirth.

"We found for the last 10 years the donor community is focused on HIV/AIDS, and it's a stubborn problem," she said. "But there are other issues that confront women and children that nobody is talking about. There's no reason women in Africa should die in childbirth."

"We are thinking what can we do to bring women's issues to the top?" Part of the problem is a shortage of doctors and nurses, she said. Throughout parts of rural Africa, the ratio is 1 doctor to every 40,000 to 100,000 patients.

Like Ban, Ali also talked about the important role business can play in solving global issues. In Seattle, she met with Microsoft, the Trade Development Alliance and the African Chamber of Commerce.

Mobile phones are now helping medical diagnosis, she said. In Tanzania, patients living 1,000 miles from a city are using mobile phones to send information about illnesses and receive diagnosis.

For all the wrangling over trade with China, the U.S. should take a look at the way it's investing in Africa, she said.

"Americans should start to think why the Chinese have gone to Africa while the Americans have not taken advantage of that," she said. Americans have been more cautious, sitting on the sidelines. Chinese have been aggressively pursuing business, and while the relationship is not always easy, they are helping Africans solve key infrastructure problems, especially in building ports, she said.

One thing that has mitigated risk for the Chinese companies is a Chinese government development fund targeting Africa. The $10 billion China-Africa Development (CAD) fund aims to promote economic cooperation between China and Africa and advance Africa's economic development by providing money to Chinese companies starting ventures there.

Ali said she hopes the United States can create a similar, large fund to help American companies bridge the gap and start to invest more in the continent to transform its future.

Such a fund could go a lot further than simply giving money to government aid programs, she said. "Give the fund to your own people to invest in Africa," she said.

"It can be done," she said. "China 20 years ago -- it was nothing, and then the private sector decided to work with them. Let's try to work with Africa."

Calling themselves "impatient optimists," Bill and Melinda Gates plan to talk directly to lawmakers and others in Washington D.C. tonight to push for continuing U.S. funding for global health.

CHUCK BURTON/ASSOCIATED PRESS

The Gates will tout the success of foreign aid, including contributiosn to the GAVI Alliance, a global initiative to immunize children in poor countries, which has prevented an estimated 3.4 million deaths over the last decade.

"In our visits to developing countries, Bill and I have met countless people who are alive, healthy, and productive as a result of U.S. global health programs," Melinda Gates said today. "We want Americans to know how much their generosity is accomplishing, and how much it's appreciated."

U.S. spending on global health has increased steadily, but it still makes up less than one percent of the federal budget. It was close to $8 billion this year, up from $1.5 billion in 2001.

The U.S. has started some ambitious development projects, even though the country's top post on foreign aid remains unfilled, and many pressing issues are vying for resources and attention.

The Bill & Melinda Gates Foundation has become an increasingly important and active player in global health and development. Its annual budget is more than $3.5 billion, and about half of that goes toward global health. The United Nation's annual budget is just under $4.2 billion.

The couple started a project called Living Proof to promote the success such funding has achieved in developing countries. Positive stories about foreign aid aren't getting told, they say.

The Gates Foundation has spent about $12 billion on global health since 1994.

Their aim is to cut the number of child deaths in half worldwide by 2025. Preventable deaths of children under five have declined worldwide to about 9 million in 2007 from 12.6 million in 1990, despite population growth, according to this report.

The presentation will be webcast live at www.livingproofproject.org at 4 p.m. Pacific.

U.N. Secretary General -- it's a position that seems both enormously important and also largely thankless, but nonetheless a job that very few people are actually qualified to do. Secretary General Ban Ki-moon, 64, has had mixed results, but as he acknowledged in an interview, he is facing an unprecedented onslaught of global crises all at once. The success of the United Nations is determined by the political will of its 192 member states, not just the man at the helm.

The vast size of the bureaucracy can be crippling, as Ban wrote himself last year: "There is bureaucracy, I discovered -- and then there is the U.N."

MIKE SIEGEL/SEATTLE TIMES

U.N. Secretary General Ban Ki-moon visited Seattle to spread the word about climate change.

Today he met with many groups in Seattle, starting with a breakfast meeting at the home of Bill and Melinda Gates, followed by a talk to the World Affairs Council on the U.N. in the 21st century and a lunch sponsored by the Greater Seattle Chamber of Commerce to address businesses about climate change and environmental stewardship. Ban also gave the Political Science Department's 2009 Severyns-Ravenholt Lecture at the University of Washington, where he received an honorary degree of Doctor of Laws at a ceremony in Meany Hall.

Under Ban's leadership, the U.N. has strengthened its role as a peacekeeper, improved the economic situation of the world's poorest, removed land mines, made progress toward nuclear disarmament and focused the world's attention on climate change, UW Regent Bill Gates Sr. said in conferring the honor.

"A great Seattle philosopher once said knowledge speaks but wisdom listens," Ban said, quoting Jimi Hendrix.

He called for a "renewed multilateralism," global cooperation that accepts "how closely our fates are interlinked" and "recognizes the rights and responsibilities of all nations."

Multilateralism is not just not just about government, he said. "It is about all of you. You and me and business and civil society organizations around the world - we all have a stake in our common future."

Ban has been visiting U.S. cities six weeks before the a major climate change conference in Copenhagen. He said he has been meeting with Senators and hopes the U.S. Senate will take action before then on a bill to limit carbon emissions.

"I was very much encouraged by such a strong commitment by President Obama," he said, "but we need now more than a commitment -- we need some actual concrete contribution by the United States."

Yesterday my colleague Sandi Doughton and I had a chance to sit down with the Secretary General for a brief conversation. Besides today's story, here are some additional excerpts from the interview.

Q: On climate change the U.S. has been one of the parties that has been slow to come to the table. The percentage of Americans who believe that climate change is caused by humans is low compared to other countries. What would you say to those people who don't believe it's real?

A: This is completely a minority view. There are some people who believe that it's not real, but I can tell you clearly this is a very minority view. The science has made it quite clear.

I have been really trying to send out such a strong message raising awareness among leaders and the general public that climate change is now happening much, much faster than one realizes.

I'm reasonably encouraged that climate change has become the top priority agenda of all the leaders of the world. On September 22, I convened a summit meeting where more than 100 heads of state and government participating, including President Obama. It was the first time that a U.S. president had attended this climate change summit meeting.

JAY DOTSON PHOTOGRAPHY

People gathered at Seattle Center over the weekend to form a giant human 350 as part of a synchronous action of 4,300 demonstrations around the world. Activists highlighted 350 as the safe upper limit for carbon dioxide, in parts per million, as a target for reducing carbon emissions. The current amount in the atmosphere is 385 parts per million.

Q: Some say the emergence of super rich philanthropies like the Gates Foundation has undermined the effectiveness of the U.N. and its member organizations, like the WHO.

A: On the contrary that is what we really want -- contributions from the business community as well as philanthropies. We need to have political support, but it doesn't give us all that we need. NGOs and philanthropies and many foundations such as Bill Gates Foundation -- they're taking a very important role. The United Nations stands in the center of mobilizing and raising awareness of climate change and food security. When this H1N1 flu broke out I immediately had a meeting with WHO Director Margaret Chan. We even convened a meeting with international pharmaceutical CEOs in Geneva. We were discussing how pharmaceutical companies could help providing vaccines for developing countries. Major pharmaceutical companies have now donated 150 million vaccines.

Q: Regarding the Millennium Development Goals, in your 2009 report you said progress has slowed if not reversed as a result of the food crisis and global economic downturn. What needs to change?

A: With this economic crisis it's natural we need to have a concern that commitment on Millennium Development Goals may be affected. During the G20 summit meeting in London I raised this issue very strongly and urged them to keep their pledges. Not much has been delivered, particularly when it comes to Africa. In sub-Saharan Africa not a single country is now on track to achieve the goals by 2015. That is why I'm going to convene another summit meeting next year. By then we'll have only five more years to go and we have to take stock. That is one subject I'm going to discuss with Bill Gates.

Q: By working in a quiet, low key manner some people say you have reduced the voice of the U.N. Do you think that criticism is valid and is there anything you plan to do to make your voice more powerful?

A: This is largely a misperception. I believe in diplomacy. Diplomacy involves open and quiet diplomacy. When it comes to very delicate matters you do not discuss these matters very openly. When it comes to universally accepted principles, such as human rights and democracy, you speak out.

The world is now going through multiple crises. Have you ever seen when whole international community has been hit all at once by all these crises: climate change, economic crisis, food security, energy crisis, pandemic? Only one of these would come once every 80 years. Naturally there is a high level of expectation of the international community for what the United Nations should be doing. I can understand the frustrations. The international community has not been able to address all the issues all at once. All these integrated issues require a global response. The United Nations operates on the basis of political will and contributions by member states.

It's too unfair if one just brings all these issues to my personal style... In Darfur there's going to be the largest number of peacekeepers in the history of the United Nations. The number, 26,000, would be bigger than all the peacekeeping operations combined 10 years ago. It was me as secretary general who made this 90 percent deployment happen. The Darfur situation from day one I have taken as number one priority. I have been fighting very seriously with president Bashir and working very hard with military generals. It was me who was able to go there and maybe save at least a half a million people. So I hope you will see the picture correctly. The United Nations has been speaking out, and I have been speaking out."

_____________________________________________________________

What do you think -- has the U.N. been effective? What should it do differently?

Last night Nicholas Kristof told the story of a boy on a beach who collected starfish washed onto the sand and threw them back into the ocean one by one. A man came along and told him he'd never make a difference, but the boy replied "It sure made a difference to that one."

What if there were thousands, or even millions of boys and girls on the beach, an entire clean up crew, and each one saved at least one starfish?

That is the possibility in cities like Seattle.

A city where each citizen is linked to another citizen of a city somewhere in the world that needs our help.

We have sister city programs where delegations of bureaucrats go visit each other and talk about expanding ties. That's the old paradigm. So here's my idea: take Seattle's enormous talents, compassion and global perspective, and scale it up.

Time for the younger generation to redefine this civic pillar and make it really meaningful.

Because something is happening here but you don't know what it is, in the words of Dylan. A whole generation is looking at the world in a new way and is hungry to change it. These are the students who pack auditoriums and line up for hours to meet their rock stars - the Paul Farmers and Kavita Ramdases and Nicholas Kristofs of the world.

Three years ago an 11-year-old girl, Jessica Markowitz, decided to help educate girls in Rwanda. She traveled back and forth, raised more than $30,000, and now she's expanding her partnership to high schools in Seattle and Kigali. At Bellevue High School Brett Mennella helped start a microfinance club, which raised more than $130,000 for a local non-profit helping poor entrepreneurs, and now five other high schools have followed his lead. There are countless other examples here and in cities across the U.S.

Everyone knows the wealth system today is unequal. As Kristof said, we who won the birth lottery buy lattes and iPods while kids overseas starve. But we as individuals have the power to change it ourselves right now, and even the technology.

The Kiva model has shown the possibilities for transformation when one person uses the Internet to send one tiny bit of her resources to one other person.

Joe Mallahan would like it, from what I hear about his ideas to use mobile phones for social business. Mike McGinn would like it, from what I hear about his enthusiasm for grassroots environmental movements.

Someone in Edmonds liked the idea, because he made sure every one of its 43,000 residents could give $1 to help Carol Schillios save girls in Mali.

Kristof also told us about a $10,000 bank mistake that saved a school in China that was able to waive $13 in school fees for each of the girls, who became accountants and sent money back to their town, which got a road built and attracted more investment, which made life better for everyone. A virtuous cycle.

What if we could change a whole town in a place like Cambodia or Cameroon, and create a new sister cities model for others? Take soft power right down to the local level.

We have 602,000 residents in Seattle, and most of them can afford a latte. Some school in some town with a poor girl who can't afford an education is just waiting for us to notice.

Nicholas Kristof, a New York Times columnist and co-author of the book Half the Sky, said the inhuman reality many girls face in the world became crystal clear when he purchased two girls from a brothel in Cambodia for about $200 each, and was given receipts.

"It's no exaggeration to talk about this as truly slavery," he said, speaking to the World Affairs Council tonight at Town Hall.

At the peak of the transatlantic slave trade, about 80,000 people were sold. Today there are 800,000 women and girls being trafficked around the world, he said.

Anywhere from 60 million to 100 million girls have disappeared from the world's population because of female infanticide and inadequate care for girls' health, Kristof said, showing photos of a skeletal child being treated in a feeding center, whose brothers were well fed and healthy.

"Every kid in the feeding center was a girl," Kristof said.

But he argued that even small interventions can transform the situation, and education is the best place to focus resources.

The U.S. has spent $11 billion in aid to Pakistan since 9/11, money which has accomplished "next to nothing," he said. If some of it had gone to education, the impact would be felt by now.

Bangladesh, by contrast, invested in girls education after it split off from Pakistan. Now there are more girls in school than boys, the country is doing relatively well and tackling its remaining problems with home grown solutions such as microcredit.

Supporting local grassroots movements for female education and economic opportunity is one way Americans can encourage change without forcing their cultural values on others, he said.

He finds the rise of social entrepreneurs a revolution that will change the world.

People want to engage in causes larger than themselves because it makes them happy, he said. Asked how he remains hopeful in the face of so much suffering, Kristof said it's because he witnesses so many selfless acts by people working in terrible conditions to save lives.

But when he comes back and sees "people who express their humanity by buying the latest car or having the latest iPod -- that is truly depressing," he said.

He advised young people to travel abroad, go outside their comfort zone, be embedded in the home of a local family.

Some people ask him why we should care about the fate of people in other countries many miles away.

"When you actually see a girl in a Cambodian brothel with her eye gouged out you don't ask that question."

What happened to the girls he bought out of slavery five years ago? Kristoff said he stayed in touch and still visits them. One is married to a good husband who doesn't know her past. The other went back to the brothel temporarily to feed her meth addiction, and later married a police officer. But now the brothel no longer exists. U.S. government pressure on Cambodia to crack down on trafficking made it risky and expensive, so the proprietor turned it into a grocery store.

Update: Almost seven months after Obama announced a stepped-up civilian effort to bolster troops in Afghanistan, many civil institutions are deteriorating as much as the country's security, the New York Times reports today. System of delivering aid is "broken."

President Obama's Nobel Peace Prize?

Yes, we can celebrate it, but "we must continue to hold the President accountable so that he can, in fact, deliver on the promise of peace," says Kavita Ramdas, CEO of the Global Fund for Women.

But holding him accountable may also mean changing our ideas of what peace and security actually mean.

In Afghanistan, possibly the least peaceful or secure place on earth, it's time for Obama to shift the balance of U.S. troops from soldiers to armies of doctors, midwives, engineers and arborists, Ramdas said, addressing the University of Washington School of Global Health earlier this week.

"Stop feeding the beast," she said. "We have too many guns and way too little butter."

Fortifying militaries might make the public feel safer, but it is eroding the actual security and well being of the world's women, she said.

Ramdas made an argument I am hearing more frequently these days: that the world's security is connected to the welfare of women, especially in developing countries.

Their physical safety diminishes in militarized settings like Afghanistan, Colombia, the Democratic Republic of Congo, Gaza and even within the U.S., she said.

"When militarism combines with the ideology of patriarchy, which accords women intrinsically lower value than men, it results in what most of the world faces today -- stunningly high levels of violence against women in every part of the globe," she said. "The scale of this violence is truly at the level of an epidemic."

Ramdas grew up in a privileged family in New Delhi -- her father is the former head of the Indian navy, turned peace activist. She runs the largest non-profit organization in the world dedicated exclusively to international women's rights. Ramdas is also one of the more outspoken members of the Gates Foundation's program advisory panels.

Almost everywhere, a large presence of troops correlates with high incidences of rape, prostitution, domestic violence and other problems, she said. "Survival sex" is common -- organizations working in such situations report that girls are often resorting to sex for food.

Conversely, where women's health and education is improved, and more females enter the workforce, countries achieve rapid reductions in poverty.

In Afghanistan, an infusion of new troops was supposed to secure control and help pave the way for more "soft power" efforts. But some influential aid groups, including World Vision, have argued that the U.S. should pay more attention to economic development, and separate that work from its military operations.

Ramdas poses a more fundamental question: "If the strategies that we used up to this point have not succeeded in ensuring the safety and well being of women and girls, what makes us think that increased militarization with 30,000 additional US troops is somehow going to improve the situation and security of women in Afghanistan?"

Asked what would she advise Obama in Afghanistan, Ramdas said he should set a time frame of less than five years to invert the balance of U.S. investments toward more development assistance and fewer military troops.

Even in the U.S., "the Third World is alive and well," she said. Close to 15 percent of the population is living below the poverty line, and 70 percent of them are women.

In 2007, 250,000 women and girls in the U.S. were raped or sexually assaulted. "How is it possible we don't see that as a public health crisis?" she asked.

"We must change the way we define health. It must be truly human security that we all fight for."

Journalists Nicholas Kristof and Sheryl WuDunn set out to write a book. By the time they were done they had managed to ignite a movement. In "Half the Sky: Turning Oppression Into Opportunity for Women Worldwide," they compare emancipating women to the abolition of slavery.

The statistics stop you cold: one million children forced into prostitution every year; three million women sold as sex slaves; more women likely to be maimed or killed by male violence than by cancer, malaria, traffic accidents and war combined.

Traveling around the world, the husband-and-wife team profile individual women who are among those forced into sex trafficking and prostitution or faced with appalling health conditions. Even more remarkable, though, is how the women overcome those circumstances and go on to change their lives and help others.

Using the Web and TV, including an appearance on Oprah, to spread their message, Kristof and WuDunn invite people to join the cause of fighting poverty and extremism by educating and empowering women and girls. One local non-profit is organizing book clubs around the country to encourage activism. Kristof, a Pulitzer Prize-winner and New York Times columnist, will visit Seattle next week, talking with educators and giving a speech Thursday at Town Hall, sponsored by the World Affairs Council. He will discuss how our own national security, as well as the prosperity and stability of the world, is tied to the well being of women.

In the week leading up to the talk, I will be featuring perspectives on the issue from local organizations and individuals working on behalf of women around the world. Do you know of one such remarkable person or group? Please share your thoughts and suggestions.

COURTESY OF NICHOLAS KRISTOF

Nicholas Kristof met a group of young refugees who had fled from Darfur in a visit to a refugee camp on the Chad-Sudan border earlier this year.

A: Gendercide is a term to describe the way millions of women and girls die around the world because they don't get the same access to food and health care that males do. It's common when food is scarce to feed sons and starve daughters, or to take a sick son to the doctor while feeling a sick daughter's forehead and saying, "Oh, she'll be better tomorrow.'

Q: At what point did you decide to go from an observer to someone taking an active role in this issue?

A: I went into journalism in part because I wanted to have an impact, but it's a delicate balance - you can't march in as a crusader into a school board meeting you're covering. But we wrote Half the Sky not so much to inform people as because we wanted to shake people up and help address these issues.

Q: What is it that causes so many societies around the world to oppress women?

A: Traditionally, what mattered in many agricultural societies was physical strength, and men tended to have more of that. In addition, conservative sexual mores and taboos about menstruation sometimes led women to be further cloistered, which eroded the ability of women to contribute to the family - and thus devalued them further.

Q: Will eliminating oppression mean that humans have to overcome something in their nature?

A: Oppressive attitudes are often embedded in culture, but we can change them. After all, Sheryl's grandmother had bound feet, and Sheryl certainly doesn't.

COURTESY OF SHERYL WUDUNN

Sheryl WuDunn won the 2009 Dayton Literary Peace Prize for Lifetime Achievement with her husband, Nicholas Kristof, for chronicling human rights in developing countries. Her grandmother grew up in China with bound feet.

A: Empowering women tends to lead to faster economic growth, which in turn tends to undermine extremism and reduce civil conflict. In addition, there's some evidence that countries that marginalize women tend to be more likely to have the macho values of a boy's locker room or an armed camp and are more prone to violence - bringing women into the picture tends to result in more security.

Q: Can you give an example?

A: One example is Pakistan and Bangladesh. They used to be all the same country until Bangladesh split off in 1971, and at that time Bangladesh seemed utterly hopeless. Kissinger described it as an international basket case. But the one thing Bangladesh did was invest in girls, especially girls' education, and today Bangladesh has more girls in high school than boys. All these educated girls then poured into the labor force and were the pillar of the new Bangladeshi garment industry, which buttressed the economy and undermined fundamentalists. All those educated women also reduced birth rates and supported civil society organizations that promote development, like Grameen and BRAC. There are other factors at play as well, but it's fair to say that partly because it educated girls, Bangladesh is more stable and less prone to terrorism and violence than Pakistan itself.

Q: You make the argument that Westerners don't invest enough in changing culture, and connect the boom in Muslim terrorists with the broader marginalization of women. If Muslim women are oppressed but don't feel they are, how can Westerners effectively change that?

A: Sheryl's grandmother probably didn't feel oppressed when her feet were bound, but with education people began to see things differently. It doesn't work for Americans to denounce other cultures as barbaric, but promoting education does have an effect, and so does supporting those within a society who are seeking change. For example, we would be more effective in the Muslim world if we did less speaking through the megaphone ourselves and did more to support women leading the way for change in those countries.

Q: You gave your own blood to try to save Prudence, a woman in Cameroon, only to watch her die when the doctor could not be found. How did that affect you?

A: It was so frustrating. I could have wrung that doctor's neck, although it wouldn't have done much for my humanitarian credentials. I knew intellectually that one woman dies a minute in childbirth, but to see it happen so unnecessarily in front of you - that shakes you, galvanizes you and is hard to walk away from. "Half the Sky" is partly a legacy of that experience and others like it.

Q: Half the Sky refers to a Chinese saying by Mao, whose Communist revolution helped emancipate Chinese women. Yet because of the preference for male babies, China today has a dangerous gender imbalance --119 male births for every 100 girls. This suggests that even revolutions sometimes fail to change entrenched cultural beliefs about the role of males and females...

A: Changing cultures doesn't happen overnight, and the son preference is deeply embedded within Chinese society. But there's no question that China has made vast progress in creating opportunities for Chinese women, and eventually I think that imbalance will right itself. South Korea used to have a similar imbalance, and now it is correcting itself as parents realize that daughters have certain advantages.

Q: Regarding health spending and women's well being in developing countries, is too much money going toward fighting specific diseases like AIDS and malaria and not enough into maternal health programs? Would we be better off eradicating fistula than malaria?

A: It's hugely important to fight malaria, and I don't think we should walk away from that. In the case of AIDS, there's a general recognition that it was a mistake to channel resources just to AIDS while leaving women to die in childbirth unless they also happened to have HIV. We need to do a better job of supporting health systems generally, and improving maternal health tends to do just that.

Q: How do you and Ms. WuDunn, practically the power couple of gender equity issues, divide your own work on the book?

A: With previous books, we wrote different chapters. This time, I wrote the subjects and Sheryl wrote the predicates. No, no, just kidding. We shared the writing and edited each other. Just as couples grow to look alike, so does their writing.

Q: All the publicity surrounding the book and movement has made you something of a celebrity (Indeed you've traveled with a celebrity, George Clooney, to Darfur refugee camps). Is this helpful to your cause?

A: I'm not remotely a celebrity, and I tend to stay away from conferences because I learn more in villages. I'm a deep believer in the need to get out and travel and talk to ordinary people and truly listen to ordinary people. But where there is interest from TV, I welcome it. I've traveled with Ann Curry of NBC to Darfur and Pakistan, and the upshot was that NBC Nightly News did a show on maternal health. A film crew did a documentary about me for HBO, to air next year, and there were times in the Congo with them that I could have wrung their necks, if it wouldn't have undermined my image as a humanitarian. But now I'm so glad they came and did the documentary, because it helps shine a light on atrocities in Congo. And shining a light is the first step to making a difference.

Author appearance:
"Saving the world's women: An evening with Nicholas Kristof," Thursday, Oct. 15, Town Hall, 1119 Eighth St., Seattle; Doors open at 6:30 p.m., program begins at 7 p.m.; cost: $40 members, $60 nonmembers, $40 students; preregister online at the World Affairs Council Website or call 206-441-5910.

People in the Democratic Republic of Congo have suffered and inflicted on each other atrocities that are impossible for many outside the country to imagine.

The country has been called the "worst humanitarian disaster since World War II" by the International Rescue Committee, a place where 5 million people have died as a result of war, hunger and related consequences over the past decade. Women's bodies have been the battleground.

PHOTOGRAPHER/SOURCE

Dr. Jo Lusi and his wife Lyn Lusi are founders of HEAL Africa, a nonprofit organization with U.S. headquarters in Monroe that trains health professionals in the Democratic Republic of Congo.

In eastern Congo, the worst hit region, military groups prey on the local population, using rape as a weapon.

In the heart of this crisis, a doctor and his wife operate a hospital and 28 "safe houses" to treat, counsel and shelter women and girls brutalized by the violence.

Dr. Jo Lusi, a native of Congo, and his wife, Lyn Lusi, who is originally from Britain, founded the non-profit HEAL Africa, which provides medical care and training for local health workers in the country's rural clinics.

Traveling from remote Goma, in eastern Congo, the Lusis visited Seattle recently, where they have a small U.S. office in Monroe.

"We come here to bring the message of congratulations from the girls to the people who are supporting us," Jo Lusi said. "We want to encourage those who are ready to help and to say Seattle people, you are great! The job is not finished."

A local women's group provided funds for two safe houses, and the group also received matching grants from Microsoft and Boeing, whose employees donated money, and support from Quest Community Church.

The story is not all bad in Congo, Lyn Lusi said. She and her husband have seen volumes, living and working there since 1985.

"This is time to tell people that the work is going well, in spite of all the bad news everyone hears," she said. "We can't stop the war, but we can be present in the communities, helping communities organize and take care of what they can, using the resources they have available."

As an example, she told the story of a girl who had been raped and dared to go to a safe house and talk with a counselor despite urging from her mother to keep quiet.

The girl was taken to the hospital for treatment and she continued to press for justice. The rapist was publicly tried, and the courthouse so crowded the trial had to be held outside. When the man was convicted, there were cheers.

"The foundation of any society is our trust in the system," Lusi said - trust that is slowly being rebuilt one case at a time. "We want to build on the strength of everybody's desire to have a functioning community."

Four years ago Jo and Lyn Lusi asked Judy and Dick Anderson, whom they had met in Congo, to start an organization in the U.S. that could support them. So the Andersons did, working initially from their log cabin in the woods in Snohomish County, where they lived in between humanitarian missions overseas.

After HEAL Africa was mentioned in the bestselling book "Half the Sky," Oprah Winfrey linked to it as one of 8 organizations helping women rape victims listed on her Web site.

"It's like David among the giants," said Judy Anderson.

To cope with the volume of traffic, supporters at Microsoft hosted HEAL Africa's site, which had received 20 online donations today within hours of Oprah's show.

Much of the violence in Congo is fought over minerals, and the area where HEAL Africa works is rich in them.

"Wherever there are minerals there is violence," Lyn Lusi said. "We're cursed by our wealth in Congo."

Everyone with a cell phone may be tied to the conflict.

The mineral coltan is used to make a heat-resistant metal powder called tantalum, a key component in everything from mobile phones to computer chips to stereos and VCRs, as this story describes.

A campaign called The Enough Project examines how demand for electronics products such as cell phones and laptops is helping to fuel the violence and seeks action by President Barack Obama, electronics companies, consumers and Congress to try to end the conflict.

Ross Donaldson went from a comfortable life as an American medical student into the front lines of the fight against Lassa fever, a neglected and deadly disease in central Africa. Now a doctor, he has written a book about his experiences called The Lassa Ward. Donaldson gave a talk at UW today and is appearing in Seattle Wednesday at the Greater Seattle Chamber of Commerce and also at Elliott Bay Books. I had a conversation with him about some of the lessons he learned and wants to share.

Q: What did the experience teach you about how make an impact in global health?

A: When I got there I started doing hands-on medical care. One of conclusions I came to is how much bigger impact you can make through training local health care workers, so it's sustainable when you leave and multiplies your impact when you are there.

Q: What do you want people to know about Sierra Leone (where he traveled with the group Merlin to work in a remote hospital)?

A: The situation is quite stark. It's the last country in the world when it comes to health care outcomes. It's really a human rights issue. When I was there 1 out of 8 women were dying in childbirth. In the U.S. it's like 1 in 8,000. I spent a lot of my time going between the maternity ward and the Lassa ward.

Q: You didn't get Lassa fever yourself, did you?

A: No, thankfully I didn't. The day after I got back to L.A. I came down with a serious illness, myocarditis, an infection of the heart. About a third of people die from it, a third are permanently injured and a third recover fully.

My mentor Dr. Conteh I really think is the hero of the book. He's a physician who spent his whole life taking care of patients through wards and at the Lassa ward. Dr. Conteh had worked there close to a decade and had been OK. All it takes is one slip one day. Resources at the hospital are limited, so he was drawing blood from a pregnant woman. A glass vial broke and he cut himself and died from Lassa fever about 5 to 7 days later.

Lassa is one of four communicable hemorrhagic fevers, similar to Ebola or Marburg. Lassa comes from rats originally. In parts of the area people eat rats as a food source -- essentially there's no other protein in the diet. Every once in a while they will eat a rat with Lassa.

Q: Eating rats and dying from fever says a lot about the overall situation.

A: It really connects how important economic prosperity is with health and how the two are intertwined, and also with the political situation. They were fighting over diamonds essentially. I went out into the field -- Merlin had projects for public health outreach - to just tell people not to eat rats, we won't have the initial outbreak and peoples' lives will be saved. I somehow naively thought this would be an easy message to tell. The older men would look at me and say I've been eating rats for years and I'm fine and there's no way I'm going to stop. At first it seemed very foreign to me and then I realized it's similar to conversations I've had here around cigarette smoking. It's part of human nature not to want to change.

Being an advocate for health is a very important part of what I do and what I think physicians should do. Doctors get a lot of the credit but the truth is medicine is really a team effort. It's really the whole system that deserves the credit. When there's a breakdown, it's really the system that needs strengthening so you can bring up the level of care.

Q: Do you think health aid to Africa has been effective?

A: As long as I have been doing this work, there have been debates about the vertical, horizontal or diagonal approach to health programs. In some ways a continuing dialogue is very beneficial to the aid and insuring you're getting the most out of it. Overall I think the aid community is doing a lot of good but continually striving to make sure you're doing the most good is the ethical and moral thing to do.

Q: What would you advise young people who want to work in this field?

A: I have noticed over the last couple years there has been a huge upturn in people interested in global health, and I think that's fantastic. It really is going to take a lot of bright young minds to deal with these problems. The money might come or go, but if you have a good feeling about helping other people that's not something you're going to lose in a recession.

For students it's important to get some kind of skills they can help out with and also to get some experience in the field. Information and opportunities are available on ReliefWeb and Devex.

Is the $8 billion the U.S. spends on foreign aid for global health worth it?

Bill and Melinda Gates say they've seen proof that it is. They're starting a new campaign today called "Living Proof" to convince Americans that their money has been a good investment, saving millions of people in developing countries.

Their message is that those children and adults are surviving and leading more productive lives, "living proof" that U.S-supported initiatives to fight malaria, AIDS, and other diseases are working.

The Gates Foundation has started a major ad campaign that will run over the next five weeks, aimed primarily at policy makers in Washington DC.

Cynthia Lewis, a senior program officer at the foundation, said the couple was struck by the disconnect between the optimism and progress they saw on their trips and the pessimism they were hearing about when they came home.

"When we talk to people in America they don't know where their money has gone or that it's working," achieving major declines in child mortality, she said.

Following media images of crying and emaciated children that helped the world see the problems of poverty and disease, this campaign will show the other side, featuring people like a woman with HIV in Ethiopia who gets treatment, starts her own barber shop and teaches others about HIV/AIDS while they're sitting in her chair.

"For quite a number of years people who advocate have focused on the need," said Iain Simpson, a global health spokesman for the foundation. "That's been a very effective campaign. What we've forgotten collectively to do is come back and say these investments we asked you to make have had a fantastic impact on peoples lives."

The U.S. government spent about $30 billion on foreign aid since 2008, about 1 percent of the U.S. budget, and of the total foreign aid, about $8 billion goes toward health programs.

The U.S. approach to foreign aid has been criticized by various groups, including Global Washington, which asserts that it needs to conform to local priorities and be more transparent.

The programs that will be highlighted by the Gates Foundation include the President's Emergency Plan for AIDS Relief (PEPFAR), which is credited with saving an estimated 1.2 million people by expanding access to HIV prevention and treatment.

Programs supported by U.S. foreign aid delivered 88 million insecticide-treated bednets to protect young children from malaria, life-saving TB treatment programs in 41 developing countries, malaria prevention and treatment for 32 million people and fortified food for tens of millions of children in developing countries, according to the campaign.

Lewis acknowledged it was a difficult case to make to Americans even before the economic downturn hit.

"We think if more Americans learn about progress in global health, they'll be inspired to maintain these investments--even in difficult economic times--so that we can do even more," Melinda Gates said in a statement.

As Afghanistan holds its presidential election today, optimism has been dampened by a lack of progress in development on the ground, say leaders of a local humanitarian group active in the country.

While completing peaceful elections would be a positive step, "Afghans I've spoken with don't feel invested in these elections because they're not seeing progress or a viable government in their own communities," said Christine Beasley, country program manager for World Vision, a Federal Way-based group that has worked in Afghanistan since 2001 with a staff of 250 on the ground, mostly local Afghans.

The Christian aid organization decided to pull its 15 foreign staff members out of the country temporarily over security concerns during the election period. They plan to return at the end of August. Local staff are suspending operations and restricting their movements.

COURTESY OF WORLD VISION

An Afghan woman in Badghis Province and her children shell pistachio nuts, earning less than a dollar for every eight kilograms shelled. The province has 300,000 acres of pistachio forest.

Currently uneven distribution of aid, lack of donor coordination and some duplication of services are weakening reconstruction efforts, Anderson said.

World Vision is calling for more attention to economic development, saying civil society resources to support education, jobs, good governance and agricultural alternatives to the poppy trade are crucial to progress.

The U.S. government needs to create a clear development strategy for Afghanistan that is separate from the Department of Defense's counterinsurgency strategy, the group said.

A coordinated development strategy means, "measuring the number of children in school and the content and quality of their education, not just the number of insurgents defeated," said Rory Anderson, World Vision's deputy director for advocacy and government relations.

Gen. David Petraeus, the head of the U.S. Central Command, spoke about the challenges ahead in Afghanistan at a talk in Seattle last month. Later this month, my colleague Hal Bernton will be reporting from Afghanistan and writing a blog from there.

COURTESY OF WORLD VISION

Women at a sewing workshop run by World Vision in Herat, in western Afghanistan near the border with Iran, are the sole breadwinners for their families. Yet they can't disclose their names for fear of reprisals for working outside the home.

"An economic development strategy is not the same as a counter-insurgency strategy--although the end goals may align, the operational approaches are very different and they follow different time frames," said Anderson. "If a free and peaceful Afghanistan is the goal, forcing square pegs into round holes won't work."

Without a distinct development strategy, "the 'civilian surge' is understood to be a military surge, which by itself will not help Afghans take control of their own country," she said.

Another local group working in Afghanistan to address the effects of war is Clear Path International. In Afghanistan nearly a million people are disabled, many because of land mines, according to Clear Path, a Bainbridge Island-based non-profit that helps land mine and bomb survivors.

Clear Path supplies prosthetic devices, builds handicap access ramps in schools in Kabul, advocates for the rights of disabled and provides employment for land mine victims through its Afghan Mine Action Technology Center, which makes de-mining equipment. The center sells the products at a lower price than international suppliers charge, and it uses the revenue to support rehabilitation services. Read more about the group's work here.

Joe Cerrell, an early Gates Foundation employee who has shaped its communications and policy strategy on global health, will be moving to London to head the foundation's European office.

He'll lead an effort to expand the office in Europe, the foundation said today. Cerrell will oversee policy, advocacy and communications and assume the role in London on Jan. 1. He is currently director of global health policy and advocacy in Seattle.

"Joe has been a senior leader at the foundation for many years and has played a central role in its development and growth," foundation co-chair Bill Gates said in a statement. "He has also led highly successful global health advocacy activities, many of which were conducted with European partners."

He'll be charged with expanding the foundation's partnerships with European non-profits, governments and other groups, as well as managing grants. The foundation currently has major partnerships with development agencies of the United Kingdom, Germany and France.

Cerrell has worked at the Gates Foundation since 2001. Before that he was assistant press secretary to former Vice President Al Gore. He is the son of longtime Democratic political consultant Joe Cerrell, of Cerrell & Associates.

Africa is getting more attention with a new U.S. administration that says it's committed to helping African countries achieve self sufficiency and food security. The Gates Foundation has also brought a renewed focus on African agriculture through its own programs and grantees, including the Alliance for a Green Revolution in Africa (AGRA).

What is the best way to move forward from decades of neglect and a recent food crisis that pushed 100 million more people into poverty?

As U.S. Secretary of State Hillary Clinton tours Africa this week, a coalition of grassroots groups says "business as usual" won't work, and criticized the U.S. for pursuing a narrow approach that puts too much emphasis on biotechnology.

SIMON MAINA/AFP/Getty Images

US Secretary of State Hillary Rodham Clinton meets Masaai traditional dancers in Kenya after addressing the 8th Forum of the African Growth and Opportunity Act (AGOA).

The US Working Group on the Food Crisis used a visit by Clinton and Agriculture Secretary Tom Vilsack to the Kenya Agricultural Research Institute (KARI) to raise the question of whether U.S. tax dollars for food-related aid to Africa are being spent wisely.

The United States and other top industrialized nations pledged $20 billion to promote sustainable agricultural development in the world's poorest regions last month at the G8 Summit in Italy.

The USAID's policies toward agriculture in Kenya, stated here, include a public-private partnership with KARI and Monsanto to develop genetically engineered sweet potatoes resistant to virus, and promote public awareness about the technology in Kenya.

(The Donald Danforth Plant Science Center said it was never involved in the original project. I had listed the Danforth Center among the partners, based on information from the USAID Kenya Web site. Roger Beachy, president of the Danforth center, said the center brought material from Monsanto and KARI to its labs and is working on the project using a different technology, in partnership with the government of Uganda).

After 14 years and $6 million, the project proved to be a failure, the coalition said, adding that local varieties outperformed genetically modified varieties in field trials.

The coalition called such policies "misguided" and at odds with a report on the International Assessment of Agricultural Knowledge, Science and Technology for Development. The report, which came out earlier this year, took four years and was commissioned by the World Bank and United Nations to evaluate the impacts of agricultural methods on hunger and poverty, rural livelihoods, health and sustainable development.

The report was approved by more than 50 governments, but not the United States, Canada or Australia.

The way the world grows its food will have to change radically to cope with a growing population and climate change while avoiding social clashes and environmental disaster, said the co-chair of the report, Hans Herren, who is president of the Millennium Institute.

"I fear within the new (U.S.) administration not enough time has been devoted to reading and digesting the report so it can be used for its full potential to address problems at the root," he said.

Herren, who received the World Food Prize in 1995 for developing a pest control program that rescued the African the cassava, said building more resilience in plants through classical breeding is a better answer than engineering for drought resistance. Climate change may produce drought but also may produce severe storms and unpredictable weather patterns. He said the Kenyan agricultural institute is on the right track in broadening its approach more recently.

The report's findings reject current industrial farming methods as a solution to sustainable food production, concluding that the benefits of modern agriculture have not been equitably shared and have come at too high a price to the poor and to the environment.

Josphat Ngonyo, head of the Kenya Biodiversity Coalition, a network of 60 community groups, said that small holder farmers in Africa have been left out of the process of determining agricultural policy.

"We find that most of African governments ignore local farmers. They are not consulted," Ngonyo said. "We see heavy manipulation by multinational companies who have their ways to influence policies and legislation."

"What (farmers) clearly need is not biotechnology," he said. "They need water, markets for farm products. They need good roads to access markets, and they need incentives that would enhance getting their products to the markets."

The Kenya Biodiversity Coalition said the visit to KARI showcases "the Obama Administration's betrayal to Africa's small scale farmers and misplaced priorities on how to achieve sustainable food security in Africa."

"Chemical-intensive production methods continue to have adverse health and environmental effects," the group said, "while 'modern biotechnology' (genetically engineered seed) has contributed to hardly any verifiable positive impacts on equitable and sustainable development."

Asked to assess the work of Gates-funded AGRA, Herren praised its emphasis on soil quality and a program to train traditional plant breeders.

"What I think is a problem is they feel they know it all," he said. "To go out here and try to replicate the green revolution is not good enough."

He said where the effort falls short is in understanding "how the whole system operates." Key road blocks include lack of market access, infrastructure and training for farmers, he said.

"There are major gaps there in the AGRA program which are not addressed to have the impact they think they're going to have."

AGRA's main programs are seeds, soil health, market access, and policy and partnerships. The alliance has said it seeks to avoid the adverse effects of the original Green Revolution in Asia and Latin America, including overuse of fertilizer, and focus on small farmers living on less than a dollar a day--most of whom are women.

Last month AGRA, chaired by former UN Secretary General Kofi Annan, launched a program with KARI and other partners to improve maize yields by counteracting soil acidity.

The Gates Foundation's own assessment of the program last year can be found here.

President Obama and other world leaders seem to be taking their cue from the Gates Foundation for a new three-year agricultural initiative announced today.

Leaders from the Group of Eight leading economies made the $20 billion pledge to finance agricultural projects in poor countries to fight hunger and reduce food price volatility.

The U.S.-sponsored food security initiative aims to provide poor farmers in developing countries with seeds, fertilizers, infrastructure and other tools to help them boost local food production, a shift from previous policy that emphasized sending food aid from abroad.

Here is what Obama said about the issue today:
"There is no reason why Africa cannot be self-sufficient when it comes to food. It has sufficient arable land. What's lacking is the right seeds, the right irrigation, but also the kinds of institutional mechanisms that ensure that a farmer is going to be able to grow crops, get them to market, get a fair price."

The Gates Foundation has focused on seeds, fertilizer, irrigation and market access in its own programs, spending $2.6 billion on global development so far, most of it for agriculture in Africa.

The world's largest foundation has taken on a major role in agricultural development since it launched the Alliance for a Green Revolution in Africa (AGRA) in 2006. AGRA funds work to improve seeds, fertilizers, irrigation, and market access for small farmers, employing techniques of the original Green Revolution started in the 1940s in an effort to boost food production in Africa.

The new grants by Gates and Rockefeller came at a time when U.S. funding for agriculture had fallen sharply. Agriculture's share of U.S. development assistance was 3 percent in 2005, compared to 12 percent in 1985, according to this report. In dollars, support for agriculture went from a high of about $8 billion in 1984 to $3.4 billion in 2004.

Now besides the Gates and Rockefeller foundations, the U.K'.s Department for International Development has become another core donor to AGRA.

Obama also talked about agriculture and his trip to Ghana in this interview with AllAfrica.com.

"I'm still frustrated over the fact that the green revolution that we introduced into India in the '60s, we haven't yet introduced into Africa in 2009," he said.

The push for a green revolution in Africa has sparked criticism and debate about the role of high-tech solutions over ecological farming methods. Obama said today that low-tech solutions are also important.

"We don't need fancy computers to solve those problems; we need tried and true agricultural methods and technologies that are cheap and are efficient but could have a huge impact in terms of people's day-to-day well-being."

The Gates Foundation has also funded policy studies and advocacy campaigns. It gave nearly $1 million to the Chicago Council on Global Affairs to fund a project on the U.S. role in global agricultural development, and Gates Foundation Senior Fellow Catherine Bertini co-authored the report.

At the beginning of the Obama Administration, the Chicago Council released the report with recommendations for a new policy on agriculture as a way to restore the United States "as a force for positive change in the world."

The report, "Renewing American Leadership in the Fight Against Hunger and Poverty: The Chicago Initiative on Global Agricultural Development," made five recommendations and more than 20 specific suggestions, calling for a renewed U.S. commitment to alleviating global poverty through agricultural development in Sub-Saharan Africa and South Asia. The recommendations include increasing support for agricultural education, research, including genetic engineering, and infrastructure.

The official support for biotech and commodity crops was called into question today in this piece by food writer Paula Crossfield.

Bill Gates has used forums such as the World Economic Forum in Davos to increase public attention to the issue, and has spent more time talking directly with world leaders since leaving Microsoft to dedicate himself to full-time philanthropy.

Gates has taken up the cause of agriculture in meetings with key leaders such U.K. Prime Minister Gordon Brown and Spanish Prime Minister Jose Luis Rodriguez Zapatero.

Former UN Secretary General Kofi Annan, chairman of AGRA, recently outlined a 10-year strategy to develop regional breadbaskets among African countries to produce staples. AGRA President Namanga Ngongi was in Brussels a couple of weeks ago meeting with European Union officials about the topic.

The food crisis itself may pushed the issue back onto the political agenda. The UN predicts the number of people going hungry will rise to 1.02 billion this year, reversing a four-decade trend of declines.

Yet today's G8 commitment also shows that the foundation's relatively new efforts in global development are beginning to have a catalyzing effect on agricultural policy, just as its health programs have helped shape the world health agenda.

Mark Suzman, director of policy and advocacy for the Gates Foundation's global development program, said today's pledge is encouraging. Leadership coming from the G8 on agriculture could be a platform for the future in the same way that a G8 agreement to support public health in 2000 helped create the Global Fund to Fight AIDS, Tuberculosis and Malaria, he said.

"It's focused on the right set of issues."

The Obama Administration is proposing a policy change that would effectively lift a ban on HIV-positive visitors from entering the United States.

The issue came up recently when a UK citizen invited to speak at a Seattle global health conference was denied a visa earlier this month. British activist Paul Thorn could not participate in the Pacific Health Summit, despite the interventions of Senator Patty Murray and Congressman Jim McDermott and appeals to the U.S. Consulate in London. Thorn protested the policy in a letter read to the Summit audience.

According to this federal notice, the U.S. Centers for Disease Control and Prevention is proposing to remove HIV from a list of communicable diseases that make non-citizens ineligible for entry into the U.S.

The CDC said the proposed change is in line with an amendment signed last July as part of the U.S. Global Leadership Against HIV/AIDS, Tuberculosis and Malaria. The amendment removed language in the Immigration and Nationality Act that explicitly prohibited HIV-positive non-citizens from entering the United States without a visa waiver, but it was not fully implemented.

"It has been almost a year since enactment, yet people are still being denied entry to the U.S. because HIV has not yet been removed from the HHS list of communicable diseases that prevent entry into this country." McDermott wrote in a letter last week to Health and Human Services Secretary Kathleen Sebelius, urging her to take action.

McDermott said he had been contacted three times over the last few weeks about the issue, both by organizers of the Pacific Health Summit and by two constituents who had friends denied entry into the U.S. at the Canadian border because of their HIV status.

Seattle's global health focus on malaria is getting the support of the largest Rotary Club in the world.

The Seattle Rotary is partnering with local health non-profit PATH, which works with African governments on malaria control efforts from a base in Zambia.

With so many organizations involved in malaria-related projects -- from large humanitarian groups to celebrities to public campaigns like Nothing But Nets and corporate efforts like Malaria No More -- I wondered what exactly Rotary would be able to do. It's still tackling polio in a final push toward eradicating the disease.

STEVE RINGMAN/SEATTLE TIMES

Mosquitoes that carry the malaria parasite cling to the I.V. tube in the Childrens Ward of the Morogoro Regional Hospital in Tanzania.

Seattle Rotary President Nancy Sclater, who traveled to Zambia recently to see PATH's work, explained that the malaria partnership is a grassroots effort that starts with Seattle Rotary members joining their counterparts in Zambian Rotary clubs.

"It's hands-on, connecting with people at a grassroots level, member to member and club to club," she said. While Rotary members continue to make trips administering polio vaccine, they can also distribute insecticide treated bednets.

Members will work together to deliver bednets in rural communities, teach people how to use them properly and provide basic health training on malaria symptoms and techniques to avoid it, she said. They will help develop a guidebook about the use of bednets and effective malaria prevention and treatment. Rotary is also hoping to bring African communities and businesses into the effort. Business ties between Seattle and Africa are growing.

"The health and productivity of people in Africa has broad implications globally," Sclater wrote in this message. "There is a continued perception that African nations cannot manage their business; however, there is striking evidence to the contrary."

Using proven strategies like bednets, Zambia has been able to cut malaria prevalence in children by more than half, and cut the number of children dying of malaria in Zambia by a third, according to PATH.

The disease kills one million people a year, mostly African children.

"We may be far removed geographically from children dying in Africa, but it is a cause that demonstrates the growing reputation and commitment Seattle has toward global philanthropy that will help improve the lives of people everywhere," Sclater wrote.

PATH's Kent Campbell said the scientific efforts underway by PATH, SBRI and others to fight the disease need help by community organizations on both sides.

"We need Rotary to support critical program gaps such as insecticide-treated bed nets, procurement, health education and advocacy and commodity management in Zambia that can be replicated by other clubs in other remote areas of Africa," said Campbell, director of PATH's Malaria Control and Evaluation Program.

The program can serve as a model in other African countries, connecting with Rotary's network of 32,000 clubs worldwide. The success of Rotary's polio efforts, while still not finished, is a reason for confidence about the new malaria project, Sclater said.

This week Rotary International announced it has nearly reached the halfway point in its $200 million goal to fund a final push against polio.

The funds announced today will be used to match a $350 million challenge grant recently awarded to Rotary by the Bill & Melinda Gates Foundation, an agreement that will provide $555 million to the global health initiative within the next three years.

This post was written by Sandi Doughton:

In the final hour of a Seattle conference on tuberculosis today, an African activist chided a room full of top health officials, scientists and other experts for their lack of action.

"The gap between rhetoric and reality grows bigger and bigger," said Paula Akugizibwe, regional treatment advocacy coordinator for the AIDS and Rights Alliance for Southern Africa.

Akugizibwe said she won't attend anymore conferences like the Pacific Health Summit, where the same people say the same things, then jet off to yet another conference for more of the same.

"We are sitting in fancy hotels, and people are dying," she said. "We've been talking about this for way too long. It's a travesty."

Many of the world's most powerful public health officials attended the conference, including World Health Organization Director General Margaret Chan, UNICEF chief Ann Veneman, and top officials from the World Bank and the Bill & Melinda Gates Foundation, one of the sponsors.

The topic of the final session was how to boost media coverage of tuberculosis and create a sense of urgency about a disease that kills 2 million people a year, mostly in the developing world.

Press coverage of the conference itself was restricted, though. Journalists were allowed to attend, but not to quote participants by name or affiliation without their express permission.

Laurie Garrett, a senior fellow at the Council on Global Relations and one of the most outspoken flamethrowers in attendance, told the group she couldn't understand why they couldn't create a sense of urgency, when the situation is so dire that officials should be "running around with their hair on fire."

For example, when nearly half a million new cases of multi-drug-resistant TB occur around the world each year, Kenya recently announced it can only afford to provide the costly treatment to 40 patients, Garrett said.

Dr. Krista Dong, who works with TB and AIDS patients in South Africa, said the conference was too focused on technology, like new drugs and vaccines and quicker ways to diagnose tuberculosis. Even if those things were available today, clinics and hospitals in Africa couldn't use them, she said. Most medical workers don't even have basic tools, like the special face masks needed to protect them from TB and prevent its spread. There's no room to isolate TB patients. Instead, they're all crowded into the same room, but then they share bathrooms with other patients.

"If you could lift (one of these hospitals) up and drop it here in Seattle, it would immediately be wrapped, quarantined and burned," Dong said.

Garrett pointed out that the little-known H8, or Health 8, made up of the world's top global health officials, meets Friday in Seattle. She called on the forum, which rarely reveals its agenda or conclusions, to take some concrete steps to help people with tuberculosis.

Post updated June 19

As global health leaders from around the world met in Seattle for the first day of the Pacific Health Summit 2009, one speaker was notably absent.

Paul Thorn, a British activist scheduled to speak today, said he was denied a U.S. visa because he is HIV positive. Thorn, project director of The Tuberculosis Survival Project, was scheduled as to participate in a discussion about the TB battle from the front lines.

The summit focuses on tuberculosis this year, drawing top global experts from government health authorities, research institutions, NGOs, pharmaceutical companies and private foundations.

In a written statement read aloud during that discussion, Thorn apologized for his absence and expressed his disappointment.

"The U.S. government actively discriminates against people who have been tested for the HIV virus and have been diagnosed HIV-positive," he said in the statement read by Lucy Chesire of the Kenya AIDS NGO Consortium.

Thorn said his application was turned down despite the interventions of Senator Patty Murray and Congressman Jim McDermott and appeals to the U.S. Consulate in London.

The U.S. policy gives people two choices: to lie on the application, committing a felony, or to be honest and have the visa rejected "because you are considered an undesirable person and unfit to enter the U.S.," Thorn said.

"I don't want to be either, but being an undesirable seemed like the lesser of the two evils, so I decided to be honest."

Thorn said the policy is wrong because many people who are unknowingly HIV-positive enter the U.S. every year. "The U.S. ban on people with the HIV virus entering the U.S. is one more reason why someone who believes that they may be HIV positive would just rather not know, putting themselves and others at risk of ill health and possibly an early grave."

If the U.S. wants to demonstrate leadership on HIV/AIDS and global health, through hosting such international health conferences, "then they need to accept that non-U.S. citizens with HIV are going to need to be there and participate."

He called on the Obama Administration to change it and others to keep up pressure to that aim. Here is a more in-depth analysis of that policy.

"I think it's outdated," said Darryl Johnson, a retired U.S. ambassador participating in the health summit. Johnson added, though, that he didn't understand why Thorn would not have been granted a waiver.

Thorn created the TB support project after fighting HIV and multi-drug resistant tuberculosis himself. He has been free of TB for more than 12 years after undergoing treatment lasting three years, Thorn said in this interview. He was infected with TB from a nearby patient during a hospital stay in the early 1990s.

(Update: Thorn confirmed in an email message to me June 19: the rejection "wasn't because I had MDR-TB, that was back in 1995 and has been cured. The visa waiver form also specifically asks if the TB is active or not. I was rejected on the visa waiver because I had to tick yes to having a communicable disease as I am HIV-positive.)

One of the key topics for the Seattle conference is the deadly combination of tuberculosis and HIV/AIDS. People with HIV are more susceptible to developing TB, and TB is the leading cause of death among people with HIV/AIDS. In fact, cases of co-infection are as high as 70 percent in some countries. A mutated version of TB that resists most antibiotics spreads most quickly among people with weakened immune systems.

Many deaths could be prevented right now by merging the two forms of diagnosis and treatment, which remain separate in most countries, said Laurie Garrett, senior fellow for global health at the Council on Foreign Relations.

"Shame! Shame! Shame!" Garrett scolded health leaders at a conference kick off dinner Tuesday night.

Tests should be worked up for both diseases "regularly, in the same place by the same people," she said. Instead, they are handled by different departments, with many cases falling through the cracks, and patients spreading TB in waiting rooms when they pick up their HIV medicines. The two diseases are much more destructive together than alone.

Tuberculosis is the number one killer of people with HIV in Africa. In Lesotho, 70 percent of TB cases are co-infection with HIV/AIDS. More coverage on that is here.

If TB diagnosis and treatment were integrated with HIV/AIDS, that alone could make more difference than all "these new drugs you're talking about," Garrett said.

In the Global Fund to Fight AIDS, Tuberculosis and Malaria, most grants go to one designated disease or the other, she said, and the U.S. President's Emergency Plan for AIDS
Relief (PEPFAR) does not adequately fund or track TB.

"How is it morally acceptable for American taxpayers to fund one disease and allow another to run rampant and kill the people they were trying to save with the funding?" Garrett asked.

Leading disease experts from the Center for Global Health Policy will call on President Obama and Congress to mount a concerted and comprehensive response to the deadly combination of HIV/AIDS and TB at a Congressional briefing on June 25.

This post was written by Sandi Doughton.

Four major health gatherings will be held in Seattle next week, all somewhat under the radar and closed to the public.

One little-known group, the H8 (Health 8), consists of the leaders of seven acronym-prone global bodies such as WHO, UNICEF, the World Bank and UNAIDS -- and the Bill & Melinda Gates Foundation, the only private philanthropy with a seat at the table.

The H8 rolls into Seattle the same week as the Pacific Health Summit, the Global Health Research Congress, and a meeting of a group called HIROS, made up of the leaders of government agencies and foundations that fund health research.

So who are all these elite decision makers and what are they planning to do?

WHO Director General Margaret Chan will be here. Also attending one or more of the meetings will be Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases; UNCEF chief Ann Veneman; and seven-time Photographer of the Year James Nachtwey.

The Pacific Health Summit, in its fifth year, brings together global health leaders and private industry, particularly pharma. This year's topic is control of drug-resistant tuberculosis. The research summit, which is in its first year, aims to piggyback on the influx of experts and help complement the higher-level discussions with the nitty-gritty science needed to inform global policies. Many of the world's top TB researchers will attend.

Both the summit and research congress are invitation-only, and some local NGOs were angry to realize they couldn't even attend a session featuring Paul Farmer. (Farmer will give a public presentation during his Seattle visit -- see details)

Journalists can attend both events -- but are forbidden to quote anyone by name or affiliation. The reason given is that participants will able to speak more freely and candidly if they know their comments won't wind up in the newspaper or on Internet.

As for any public or press access to either the H8 or HIROS?

Forget about it.

Little has been published about the H8 and its proceedings. Its meetings are described as "informal" and a few Web entries say its goal is to help the organizations work together to achieve the Millennium Development Goals.

George F. Russell, Jr., makes a point of informally surveying 100 people on a regular basis to gauge perceptions of Muslims in the United States. Those perceptions have been improving lately, he said.

ERIKA SCHULTZ/SEATTLE TIMES

George F. Russell, Jr., talks with friends at a dinner where he received the Woodrow Wilson Award for Public Service.

"I think it's getting a little better," he said Wednesday evening in Seattle at a reception honoring him for his contributions to public service. Russell was given the award by the Woodrow Wilson International Center for Scholars. One of his priorities is bridging the gap between Muslims and non-Muslims, which he has done through founding the non-profit collaborative One Nation.

Russell said the idea behind One Nation was to address American misunderstanding and fear of Muslims and Islam in the aftermath of 9/11. "Fifty percent of Americans felt that Muslims were bad people," Russell said. He concluded "If we're not able to change that perception, we'll end up with a 100-year war."

Russell called President Obama's efforts to repair relations with the Muslim world "a good thing."

"Reaching out and talking to the other side is really constructive," he said. "The old habit of distrust doesn't get you anywhere."

Besides One Nation, Russell chairs the Russell Family Foundation, the East-West Institute, the National Bureau of Asian Research, Nuclear Fuel Cell Technologies Inc. and the Business Humanitarian Forum.

He is best known in the world of finance, building the Frank Russell Company started by his grandfather into one of the world's leading investment advisory firms.

Russell said simple principles helped him succeed in life, such as valuing integrity, taking risks, being creative, hiring people smarter than himself, recognizing luck, sharing the credit and having fun.

"These are the ground rules that will help you do the right thing in the eyes of your grandparents," he said. Quoting Woodrow Wilson, he added: "You are here to enrich the world... you impoverish yourself if you forget the errand."