World Malaria Day 2011 and the Nuru Healthcare Worker Model

The video above chronicles the beginnings of the Nuru International Community Health Worker(CHW) Model--which is currently doing amazing work in Kuria, Kenya. Just a few weeks ago, I had the opportunity to see how the model works first hand by traveling with a Nuru Healthcare Field Officer.

During the months of March and April, a big focus for Nuru's CHW program has been Malaria. Malaria is a preventable ailment that takes the lives of 2,300 people daily around the globe. Sixteen percent of children under five in Africa die because of malaria. Imagine dying from a mosquito bite. When I was a little boy, my body would be covered with welts from mosquitos, and even as an adult, no-see-ums love to attack me. Had I been born in a different longitude and latitude, I would probably not be alive to write this blog post. At least not unless someone had educated my family with regard to malaria prevention.

And that's just what the Nuru CHW's have been doing in villages all through Kuria, Kenya. They visit people's homes and talk to them about what causes malaria, what the symptoms of malaria are, and how malaria can be treated. More importantly, during this time, they talk about how malaria can be prevented.

That's the good news, malaria can be prevented. With proper use of a bed net, malaria risk is significantly lowered. While everyone can benefit from this knowledge, the groups at highest risk are children under five and pregnant mothers, and so Nuru is working specifically to help these at risk populations. As CHWs travel from house to house, they not only talk about the benefits of bed nets for malaria prevention, but they also sell bed nets at a low cost to families. This assigns a value to the net, and it also saves a family the challenge of traveling to a town or medical center to purchase this low cost malaria intervention. The health workers also walk through how to properly use a bed net and even how to repair a net if it becomes torn. If someone doesn't know how to use or repair a tool then it will do them very little good.

Nuru's focus on prevention through a CHW model via sales of bednets as an intervention, particularly for pregnant mothers and children under five sets the organization in a unique category for stemming the tide against malaria.

As I write this post, I find myself reflecting back on my childhood, and the mosquito bites that would appear on my arms on summer nights, and I am thankful that families in Kuria, Kenya, are now equipped with the tools to prevent malaria.

Will you help Nuru continue to empower even more families with tools and knowledge to prevent malaria and so much more? Also, if you'd like to learn more about our CHW program and our work to fight malaria, check out this great article in the San Francisco Chronicle. Thanks for being part of lasting change for the people of Kuria, Kenya.

The Five Dysfunctions Of A Team

Over the years and at various places I've worked or visited, I've heard people mention this book by Patrick Lencioni called The Five Dysfunctions of a Team.  Finally after many years of conversations where the book has come up, I have been able to read it.

I'd highly recommend it to anyone who works on a team, whether it is a sports team or a leadership team.  The book is extremely easy to read (it's written as a fable), and it covers five areas for growth for any team.

What are these five dysfunctions? I've included them below. They are listed in the book as a pyramid with each one building on the other. In my list below the pyramid is inverted, and so the first dysfunction to deal with is at the top of the list.

Absence of Trust This is the the foundation of problems on teams and in organizations. If people don't trust each other, they will be unwilling to share weaknesses and ask for help because they will believe that other members of their team will pounce on these weaknesses. The solution is to cultivate a willingness to be open about weaknesses so other members of the team can help move things toward the win.


Fear of Conflict People are afraid of conflict. We 'extend grace' and 'foster harmony' and avoid hard conversations because they are, well, hard. And as a result, the teams we are on suffer. Now conflict isn't always good. If people are tearing each other down constantly or the conflict becomes rooted in personal attacks over moving more aggressively toward a win, then the whole team suffers, and trust is eroded.


Lack of Commitment It's hard to move forward toward any goal if people aren't committed to making it a reality. Our generation is extremely tentative about commitments, we are in a world that is quickly moving, and we long for fluidity, so commitments feel kind of, committing.  When we fail to commit to a course, a plan, or a specific direction, we can flounder, and never quite move forward. It's kind of like driving a car. When we start the car moving, it becomes much easier to adjust our plans and directions but we have to be willing to set forth in a direction, or we go nowhere.


Avoidance of Accountability People don't like to be accountable for anything. When we choose not to be accountable or hold others accountable, we see a lowering of standards. Often we can be wracked with guilt for holding another person accountable for their contribution and it prevents us from holding to standards--this hurts the entire team.


Inattention to Results When a team loses focus on results that benefit the win for the whole team, then individual players become concerned with their own status and ego being satisfied. This happens when individuals become more concerned with advancing their own careers or receiving accolades rather than seeing the team move to a win.  A great example might be a person on a sports team who is more concerned with their own stats than they are with whether their team is winning.  Wins take on a more selfish and personal nature, and team members are working toward boosting their own career rather than the health and vibrance of their team.  When this happens, the team loses sight of it's big win, and never fully achieves it's potential.

As I share this synopsis, if you've ever been on a team, you've probably experienced one or more of these dysfunctions. They are part of our nature as human beings, but to become a truly successful team or organization, they need to be challenged and overcome. Unfortunately, it takes more than an intellectual assent to these to make that a reality.

I highly recommend the book, but even more than reading the book, I want to encourage you to examine your own life and involvement with teams to determine how you can eliminate your tendencies toward these dysfunctions and help others do the same.  Our world needs people working together to accomplish great transformative dreams and to help this world become a more beautiful place than we could ever make it alone.

Nuru International's Research Field Coordinator and My New Friend Julius

The guy in the photo standing next to me is Julius Nyamohanga. He's twenty five years old, and he's the first person who greeted me when I arrived in Nairobi, Kenya at the Jomo Kenyatta International Airport last week. As I came out of baggage claim, I walked into a huge hall filled with people waiting for others to arrive. Julius was holding a beautiful Nuru International sign, and immediately welcomed me to Kenya.

He and I had about two hours to wait for the rest of the team to arrive, and he offered to have me shuttled to the apartment where we would all be sleeping later that night. Of course I refused--who needs sleep after flying 8000 miles in 2 days--especially when there is an opportunity to share stories.

So Julius and I made our way to a litte coffee shop in the airport and started chatting about life, the weather, my flight, and how we started working for Nuru.  As Julius began his story, I didn't take out pen and paper, but simply listened and what follows is my best attempt to recall the details as he shared with me.  I asked his permission to share his story and stories from his community with others, and he was grateful both that I would ask, and that I would be willing to share.

Julius lost both of his parents at a young age, and is the oldest of six siblings. Amazingly, he has been the provider and caretaker for his brothers and sisters since his early teenage years. When many children in the west are thinking about school, sports, and playtime, Julius was thinking about how he would insure that his brothers and sisters were cared for, had food to eat, and were able to go to school. Julius is an incredible example of hard-work, dedication, and service.  Julius farms a small plot of land where he works hard to insure that his siblings have enough food to eat and that he can earn some extra money through selling any surplus maize produced.

Beyond caring for his own family, since Julius' teenage years, he has been involved in community activism. He started a self-help group for vulnerable women in his community (HIV Patients, second wives, single mothers, widows, etc.), and has volunteered with the Kenya Volunteer Development Association (KVDA) for about ten years (since he was in primary school!). Right now, he maintains all of those responsibilities, and he works as Nuru Kenya's Research Field Coordinator.

As Julius shared his story with me, I had to work hard to fight back the tears. He and I both lost our mother's to cancer, but he was far younger, and was charged with an even greater responsibility after the death of his mom. I thought about my own teenage years, and how carefree they were--and how frivolously I spent much of my time. And then I thought about Julius working in the fields to make sure his siblings had food to eat and could pay their school fees, raising his younger brothers and sisters without guidance and direction from his own parents, and then giving of his time to help others in the community better their lives.

After the rest of the team arrived, Julius took us to an apartment in Nairobi, and began preparing a meal of eggs, rice, tomatoes, and cilantro for us as we began acclimatizing ourselves to Kenya. The next morning, he guided us to our bus, and paid for our fares as we set out on a 5 hour bus ride to Isibania from Nairobi.  He did the same thing for us on our trip back to Nairobi, traveled with us both ways, and guided us all along the way.

He taught me a few phrases in Kiswahili and Kikuria as we sat together on the bus, but more than that he taught me a great amount about service, about sacrifice, about family, and about friendship through his life and stories as we traveled. As we were parting ways, I thanked him many times for all that he was doing for his family, and for Nuru.  And, I asked him how to say two other phrases in his Kikuria mother tongue and then I called him by those phrases.  The phrases? muramwito na msalani (brother and friend).

I am honored to call Julius my brother and friend, and more honored that I get to share his story with you. Even more than this, I'm honored to serve together with him and many in Kuria as we work to end extreme poverty, together, one community at a time.  Will you join us?

Arriving Back to the United States After a Brief Stay in Nuru International's Kenya Project

The photo above was taken in Amsterdam near Centraal Station during a brief stopover I had between flights as I returned from Kenya. It says, "Terugkomen is niet ketzelfde als blijven" which means "Returning is not the same as staying."  My friend Eric Asp pointed out the sign to me as we were making our way through this beautiful city during the early morning hours Sunday morning.

The sign is incredibly true. Returning I am a different person than I would have been had I simply stayed. Sure I would continue in the work I am doing for Nuru and in telling the stories that I have known about what Nuru is doing, but now things are pretty different for me. The time spent in Kuria has made this issue even more central to my life, my mission, and my purpose on this earth.

I carry the dust of Kuria in my clothes and on my shoes now, and the people of Kuria in my heart. Last night, as I slept in my own bed for the first time in several days, I found myself awakening confused and disoriented and wondering where I was. I woke up twice in the night to go to the bathroom, and felt around to crawl out from under the bed net on my bed only to discover both times that I was not under a bed net. Because of the place in the world where I live, I don't have to worry about a mosquito bite causing me or my children to suffer and die. (I do have to take anti-malaria medication for the next week though just to be on the safe side). When I woke up this morning, I had planned to take it easy today, and to adjust back to life here slowly, but I feel a tremendous burden and a great urgency to engage others in confronting the crisis of extreme poverty and help our global neighbors to lift themselves out of their condition.

I know that returning is not the same as staying, and I also know that the opportunities that have been afforded to me to witness both tragedies and triumphs in Kuria firsthand are not that readily accessible to everyone. At the same time, I hope that my life experiences and the stories I tell can help others get a better grasp of how they can make a difference in this world and awaken to the need as well as the opportunity to serve others and love our neighbors well.

I hope to share more stories of some of the wonderful people I met while away, either in this blog, or in face-to-face conversations with you and others. In the meantime, I will continue to reflect upon my experiences and adjust to life back here in West Virginia.