I worked for 3 months in 2009 as a volunteer in Sierra Leone with Global Action Foundation (GAF). My background is in management and operations, so I spent significant time reviewing their organizational structure, coaching and basic IT training. I was working in GAF's clinic upcountry in Koidu District 80% of the time. I was deeply moved by the work GAF is doing to provide primary health care to civilian amputee victims (and families) from Sierra Leone's civil war. This population was already representative of the so-called "bottom billion" - the poorest of the poor and then, they lost hands, arms, or legs to vicious thugs wielding machetes during the war. Both sides in the conflict were guilty of this horror. GAF was founded to provide sustainable primary health care to the largest concentration of amputees, who live in small villages outside Koidu Town in Kono District. These folks have almost nothing - those of us living in developed countries cannot even imagine their lives - no work, no money, dirt floors, sickness, hunger and what little life they had was shattered by the war. Without GAF, they would have no access to modern health care. With GAF, they can get relief from a range of debilitating illness, including malaria, parasites, and diarrhea. Pregnant women can receive basic prenatal health care, leading to health births; wounded laborers can avoid severe infection; young children can avoid life damaging infections. GAF provides their services at no cost to amputees and their families and at very low cost to the general poor in the area. On a budget of ~$65,000 per year, they are treating 500+ patients per month. They are doing miraculous things with very little money. These guys are the real deal. The founders, Dr. Dan Kelly of the USA and Dr. Mohamed Barrie of Sierra Leone are truly amazing people. They have both given up significant opportunity to found and build GAF/NOW. I am over 60 years old, have traveled extensively and have met 1000's of people in my life. These folks are in that special category that you feel privileged to have met. They had a vision, found the resources, gave up much more lucrative opportunities and struggle every day to expand their operation in Sierra Leone. In addition to the clinic, they provide weekly site visits to amputee villages that are too far for residents to walk to the clinic. They are developing an intern program for premed students from the USA (2 in 2009; 4 in 2010) that will target community health care initiatives for local high schools and colleges. They will be hosting a team of training doctors from the USA in 2010, who will provide speciliaty training, not only for GAF/NOW personnel, but also for the regional hospital and government clinics in neighboring Districts. In partnership with the amputee community elders, they are building a 100 acre palm oil farm, one acre at a time. Once the entire 100 acres is developed and when the palms reach bearing maturity after 4-5 years, it is expected that the income from the farm will cover a significant portion of the operating cost of the present clinic. In addition, it will provide several permanent, decently paid jobs for the community, as well as, many paid jobs during development and harvest. Dan and Mohamed are building a model that can be leveraged across the poorer countries of West Africa. I was concerned about the impact of Sierra Leone's rampant corruption on the functioning of the organization. Early on I posed the question to Dr. Barrie, with whom I spent most of my time while in Sierra Leone. He provided an answer that would work in any society. He said that in his experience ~30% of his people are so corrupt as to be unreachable, while ~10% are incorruptible, not matter what. The other 60% will move one way or the other, depending upon their environment. Dr. Barrie said that GAF/NOW's challenge is to staff one or two of the 10% that are incorruptible and then select the best candidates for the remaining staff. It is likely that someone from the 30% will slip by, however, that can be addressed by establishing policies that include open decision making, rigorous review of money in/out, careful and regular inventory, constant reference to the importance of candor and honesty and a watchful eye. This will allow the core team to identify someone acting dishonestly and remove them from the team (one person was caught while I was there stealing a few $/month and was publicly and quickly fired). In addition, GAF/NOW pays fair wages and provides career security wherever possible, unlike virtually any other Sierra Leone managed rural health care provider. I am deeply thankful for my time with GAF/NOW. It reinvigorated my view of the world. With people like Mohamed and Dan "out there", I can see that even the worst situation can be ameliorated.
Review from Guidestar
I had the opportunity to volunteer with GAF for 3 months at their clinic for the amputee and war wounded communities in the area around Kono, Sierra Leone. I worked with the country director, Dr. Mohamed Barrie, as well as, all the clinic staff. I came to deeply respect the work GAF (registered the NGO, National Organization for WellBody, in Sierra Leone) is doing on the ground for some of the most challenged people on our planet. I would recommend this organization to anyone, including volunteers, professionals, grant making agencies and government institutions.