Jeremy's Journeys

There are about twice as many taxis in Lima as are necessary.  It’s a buyers market.  If you don’t like the price of one taxi, you can easily wait for another.  Bargaining generally works out well for the traveler.  But on Saturday, I wish we had waited for a different taxi.

My volunteer friends and I were going to see a Cumbia concert (Peruvian Cumbia is a mix of Pop and Latin music that everyone here is obsessed with).  After bartering for a few moments, we decided that we had a reasonable fee, and we wanted to just get to the concert.  The fee was 28 soles (Peruvian currency, about 10 dollars).  We told him we were going to a place near the Megaplaza.

While conversing, we told him we were Americans.  He asked if we were Christians, we told him no.  Our conversation was short, and in our opinion, he was a bit rude.  But that happens with taxi drivers and it’s no big deal.  We ended up driving a little past Megaplaza, by about 1 km.  When we got to our destination, the driver asked for a little more money because we had passed our stated destination.  This is a common taxi tactic: They ask for a landmark, and then when you don’t go exactly to the landmark,  they attempt to charge you extra.  Usually, I don’t give them anything, but this time, we gave him 30 soles just to make it an easy payment and avoid asking for the two soles back.

The extra two soles were apparently not enough, he wanted an five extra.  To which I responded that we were not going to pay.  If I were by myself, I would have gotten out of the car, and that would have likely been the end of it.  But, my friend wanted to avoid an argument, so she wanted to pay.  But she didn’t have the money.  Which led to me arguing with the taxi driver for a couple of minutes while waiting for my friend to get out.  This was the opposite of the intended effect.

Right before she had gathered up her change to pay, the agitated taxi driver implored me “But this amount of money is nothing in your country, it’s only 10 dollars.”  And that’s when I really got upset.  But my friend was paying, so I we got out, and I was left to stew on it.

I don’t mind the extra haggling, nor the extra haggling because we are Americans, but it was the incessant rudeness which he demand his money because we were Americans that bothered me.  And we knew it was unfair.  But it does beg the question, just because we can pay more, should we pay more?  Is it right for places to charge foreigners more for things?  I like to consider myself more than a tourist, I am a person  who lives in Peru.  I don’t feel I should pay more for a taxi than a Peruvian does, but in the end, the taxi driver probably needs the money more than I do; however, he should not feel entitled to it any more than I feel entitled for my opportunities because I’m American.

Conversely, I would argue that those who can’t afford to pay should pay less than those who can.  My job here, for example, is dedicated to giving a preferential option for the poor in health care.  That is something I believe in.  And maybe if I thought that the taxi driver were in the business of giving a discount poor people, which was covered by his taking advantage of foreigners, I wouldn’t have minded.  But I doubt that was the case.

For those of you who don’t know, PIH has been a pretty influential organization in the Health World.  Its charismatic co-founder, Paul Farmer, is working with Bill Clinton to be a Special Envoy to Haiti (whatever that means, but it sounds important).  They have treated patients all over the world, in areas that, because of geographic isolation, were once thought impossible to reach.  They now work in 11 countries around the world.

Probably their first large-scale policy change came in their treatment of multi-drug restistant tuberculosis (MDR TB) in the mid-nineties.  The World Health Organization’s (WHO) official stance on MDR TB was that it was not cost effective to treat, and did not pose a major threat (potentially because those who had MDR TB were dying without treatment).

PIH’s contacts in Peru begged to differ.  They knew many people with MDR, and they knew it was spreding rapidly throughout  the marginalized areas of Lima. So they went about studying and treating a group of people with MDR TB, the largest cohort ever treated up to that point: 10 patients.  And they found cure rates better than those in the United States.  They were able to barter with drug companies to lower the prices of MDR TB drugs and, in 1998, change the WHO’s policy on MDR TB.  Furthermore, they have been working with Peru’s Ministry of Health to have them adopt their MDR TB treatment program nationally.  In March, PIH in Peru held the a week-long conference training the WHO in TB treatment.

Yes, so they’re kind of a big deal. But the idea behind their success is not revolutionary. They use community health workers.  What that entails is training members of the community to visit patients, make sure they take their medicines, and provide them with support.  This idea works so well because these health workers have either been patients in the past, or have had someone close to them who has had to get treatment for TB.  They know what it’s like to take medicine every day for 6 months, or in some cases of MDR TB, a year and a half.  They know what the patients are thinking and feeling.  They know what the community needs and have ideas how to help with that.  They know it’s worth it to treat patients. They are not doctors, nurses, or statisticians from outside, but people who have grown up their entire lives walking the same streets that they walk to visit patients.  They can’t meander five minutes through the community without getting stopped and asked for help.  And they do help.  It is because of this community-feedback mechanism that PIH has developed it’s mission of integrative health, a topic which I will touch on next week.  But just so you know, these big policy changes and idea shifts did not come from Paul Farmer, they came from people in the community.

I must first apologize for being MIA (not the musician) for the past month or so. I’ve been getting my feet wet in Lima, Peru, which is considerably larger than Guatemala City. I meant to have a get together in Ann Arbor before I left, but since my turnaround was so quick, I did wasn’t able to get that together.
So what am I doing in Peru? Well, I’m working for Socios En Salud (SES), Partner’s In Health’s Peruvian sister organization (You may have heard of Partner’s In Health through the book Mountains Beyond Mountains or through their work in Haiti). I’ll be working with microfinance again. But with a different twist. These loans will be zero interest loans for patients who have recovered from tuberculosis. Tuberculosis (TB) is a particularly debilitating disease because, for the first month or so of treatment, you have to stay in your house, without having much contact with the outside world so you don’t spread the disease. And that is for the people who catch TB before it is bad. If they are already have coughing up blood and very weakened or if they have Multi-Drug Resistant TB, that rehabilitation is longer and tougher.
It’s not too hard to imagine that many of these patients loose their jobs and ability to generate income for their families. Well, my arm of SES works to help them get back on their feet after they have been cured. Here is a PBS video on what we do:

I’ll be sure to take a more in depth look at things as I get a better idea of what work I will be doing on the ground. Feel free to email me with any questions or comments. Later this week, I’ll be posting about my experience getting caught in a miners’ strike. Have a good day.

I’d like to be able to have a conclusion to my wonderful Kiva journey.  I’d like to tell you that microfinance unequivocally helps to alleviate poverty.  I’d like to tell you that in 20 years, there will no longer be people who starve to death in Guatemala.  But I have no certain thoughts.

I have for three months seen a country silently fighting to get over its bloody civil war and move forward as a people.  I don’t know how they are going to move away from penury and towards solidarity. Nor do I know what role foreigner aid/loans/help should play in this process.  I’m  left with little practical or tangible to tell anyone about my time here as it relates to solving poverty.

In this time, however, I have seen mothers who sacrifice their health to work three jobs so their kids can go to school.  I have heard stories of entrepreneurs who used to sell their goods on the street, only to now have a store to sell them in.  I have touched the glimmer of hope that is present in a person’s eyes when they know you believe in them.

Two of my favorite Spanish words are homonyms:
Esperar - to hope; to wait
Compromiso- a commitment; a compromise

To raise yourself out of a bad situation requires all of these things: hope for the future, waiting for better times, a commitment to work hard, and a compromise of  your immediate well-being for hope of a better future.  I don’t know how Guatemala, or the world, will move forward, but I believe that do so in a positive way will require these things from people.  And so I will return home committing to hope for future.

Thanks for all of your wonderful support.  It would not have been possible to make this journey with all those who helped me along the way.  You know who you are.  I’ll be home at the end of February, and I will be sure to have a presentation for those of you who are in the Ann Arbor area.

As I finish up my time as Kiva Fellow, one of my tasks is to write a mass journal to all of the people have lent to FAPE’s entrepreneurs in the past few months.  It’s aimed at people who do not know too much about Kiva other than giving a loan.  For those who have been frequent followers of my blog, you might find some of the explanations things you already new.  For those who are not frequent readers, it’s a great start to get to know Kiva, FAPE, and the world of microfinance.  I still want to edit it a bit more, but the final draft will end up looking something like this:

For the past three months, I have been happily serving as a Kiva Fellow with FAPE, Kiva’s field partner in Guatemala City. As you may already be aware, all of Kiva’s loans are disbursed by its field partners to make the process as efficient as possible. It is the purpose of a Kiva Fellow to work with Kiva’s field partners to propagate Kiva’s core beliefs. FAPE and Kiva have been working together for over two years, helping to lend more the $215 thousand dollars to Guatemalan entrepreneurs; In my time here, I have been able to witness many of the successes and hardships faced by both Kiva borrowers and FAPE.

What has most surprised and excited me has been FAPE’s dedication to the Guatemalan community here in the areas surrounding the capital. All of their loan officers—the people who actually hand the checks over to the entrepreneurs—live within the communities that they serve. This means that not only do they get to know Kiva entrepreneurs, but they also go through some of the same living experiences that Kiva entrepreneurs go through.

One of Kiva’s main goals is to extend access to credit to those who have been left out of the economic system. Because of the large Mayan heritage in Guatemala (about 40% of the population according to Wikipedia), many Kiva entrepreneurs do not speak Spanish but rather one of 22 Mayan dialects. This could be a reason why some of them have had difficulty accessing credit in the past. But with FAPE’s integration in the community, this is not a problem, as the loan officers also speak the languages that the Kiva entrepreneurs speak.

Bertha and her daughters at the Christmas Party

Bertha Carmelina Tohon provides a poignant example of this communal feeling. She lives in the small town of San Martin, just outside of Guatemala City, where she has a local eatery. She first started receiving small loans to invest in her restaurant as part of a group of women. When she proved that she could pay back her loans on time, she was able to get a larger individual from through Kiva. Whenever I visited her town, she always made sure that I ate lunch at her place, which usually was a thick, corn-based stew typical of rural Guatemala.

In addition to her restaurant, she also has two other businesses: a typing school and making clothing. If you ask Bertha why she works so hard, she’ll tell you it’s for her kids’ futures. And right now, with the help of Kiva and FAPE she is able to move ahead supporting her kids. One of kids, as I write this, is finishing studies to become a doctor. And here I stumble upon one of the beautiful things about microfinance—with a loan, not only are you helping the entrepreneur, but you are also providing a brighter future for her children.

In December, FAPE invited Bertha to cook at the annual Christmas party. She obliged and whipped up one of her delicious stews for the occasion. FAPE was supporting Bertha. Bertha had been funded by Kiva. It was a joyous representation of Kiva’s mission: connecting through lending to help alleviate poverty.

Thanks for continuing to support FAPE and Kiva. Click here see FAPE’s loans currently fundrasing on Kiva. Click here to join FAPE’s lending team.

Sincerely,

Jeremy Lapedis

A while back I had some posts on whether or not I thought microfinance worked (Part 1, Part 2)

Part of my job here at FAPE, is to try and measure how they are doing.  The tool which Kiva wants me to use is a 80-question survey that has been designed and refined to measure the social performance of a particular microfinance institution (MFI).  This is an example of a question

Does the MFI provide small loans (≤ 30% GDP p.c.) that can facilitate access for the poor?

Definition: Small loans = The amount, on an annual basis, is below 30% of annual GDP per capita. Example: In a country where GDP per capita is USD 1000, small loan = amounts below USD 300 disbursed for12 months. If the duration is 6 months, the amount disbursed must be inferior to USD 150.

0 = small loans < 30% of the total number of outstanding loans

1 = small loans < 50% of the total number of outstanding loans

2= small loans ≥ 50% of the total number of outstanding loans

The survey is called CERISE.  CERISE’s goal is to measure an MFI’s performance in distinct categories as a method of comparing one MFI to another, and as a method of letting the MFI know what areas the MFI is potentially weak in.  This chart–derived from FAPE’s data–an example of how to visually represent what we are trying to say. As you can see, FAPE does a pretty good job with economic benefits to clients, empowerment, and pro-poor methodology; however, it is clear that FAPE is weak in several areas, most glaring of which is client participation.
But the results must be take with a grain (or two) of salt. Not every MFI has the same goals. FAPE, for example, has empowerment of women in it’s core beliefs, but client participation is not a part of their principal values.  Also, as I said in earlier posts, it’s not easy to measure empowerment, but you can sure try.

Every training, the old class of Kiva Fellows welcomes the entering class. We decide to make a welcome rap video. I’m scattered throughout the video, and it’s great, so you should watch the whole thing. But if you want to skip to 2:44, that’s where my most prominent role is.

Hand made goods from women in the correctional facility

Yesterday I went to visit an incarcerated Kiva client in order to do a journal update.

FAPE has a program where they give women in jail trainings and a loan for their businesses while incarcerated.  Except where I went yesterday wasn’t a jail.  It was a correctional facility.  And that was the problem.  Let me back up a bit.

About one year ago, FAPE initiated this program in the jail in Guatemala City, four of the women were Kiva clients.  Training programs were given.   Loans were being repaid, and the women were even putting money away in savings.  The program was a success.  In late Summer of 2009, two things happened: the women were moved from the jail to the correctional facility and FAPE changed directors.

The new facility, from the looks of it, appears very nice.  There is a courtyard, two chapels and it appears to not be too stringent.  For most, it would be better than the old jail these women were in, but for these women who had established businesses, it was not.  They did not have the connections, the resources, nor the knowhow to operate in their new location.  They started to become delinquent on their loans.  And with the change of directors here at FAPE, the training programs were left by the wayside.  In there nice, new correctional facility, they had been forgotten.

Our visit to the facility yesterday was the first time anyone from FAPE had come to see them in six months.  Unlike most people who are delinquent on loans, they chastised us for not coming to visit them sooner.  Of course they did not have the money to pay us now; they had not received support from us in some time.  They wanted to pay back their loans, but they just couldn’t.  Imagine if you had to pick up your business and move to a completely different town, and you could not use any of your former suppliers or connections to get started again.  Of course they were late on their repayments.

But while complaining to us, you could also tell that our visit lifted their spirits.  It animated them to get back to work on their businesses.  They were happy that someone had remembered them.  That they hadn’t lost all of their savings they accumulated from the previous jail.  That they could share their feelings with someone who would listen.

And that’s the beauty of Kiva.  If I hadn’t needed to do a journal update, who know’s when these women would have gotten a visit?  Kiva is about giving people a chance to share their stories.  To allow people to believe that the world cares about them when all other signs say that the world is staunchly apathetic to their lives.

On Friday, we had another celebration for FAPE’s 25^th anniversary. This time, it was only the people who worked in the office. Needless to say, I was much more comfortable and happy with this crowd. We went to a park of Mayan ruins called Tecpan, which isn’t as spectacular as Tikal, but we had the park to ourselves.

First up, the religious devotion that takes place every Friday. Next up, sharing stories about different entrepreneur’s successes. About how they have to run three businesses to make ends meet. About how they can send their kids to school. About how happy they are to receive their loans. And what anniversary would be complete without the opportunity for me to stand up and be awkward? This time, the award was for me personally. In the video below (the audio is not very good), I am in front of all of FAPE thanking them for the time that I’ve been able to spend with them.

Then the festivities really began.  This group of 40 Guatemalan financial workers and one american volunteer, played team building games.  It reminded me of being at camp.  We passed a lemon down a line using only our necks.  We built 3-person skis out of planks of wood and string.  We played pin the tail on the donkey.  After all those organized activities, I taught them how to play frisbee.  After the rompus, we ate what I would describe as a Guatemalan barbecue.

And finally, we went to visit the ruins where a, Mayan ceremony had just taken place.

Now that’s my type of anniversary celebration.