Access to quality and affordable health care is critical to protect the poor from financial shocks that could push them further into poverty.

Our strategy to improving health is a bottom up approach: through our Credit with Education methodology, people learn practical ways to prevent as much a possible, to manage at home common illnesses and to seek appropriate care for more serious conditions. Currently we are implementing learning session to help people to better understand and utilize existing public and private health services.

To access those services our partners in developing countries offer health loans and health savings accounts to their clients and their families. They also develop agreements and contracts with private and public health services to increase the coverage of their services, to complement each other, to recover some costs in the case of public services and to earn a fair amount in the case of private services.

These are really new models of health care that could be adopted and replicated by ministries of health at local, regional and national levels.

Ill health is not just a matter of unnecessary human suffering and premature deaths--it is an economic burden for the poor. People who are sick are less productive and/or have fewer opportunities to engage in income generating activities. If people do not know how to improve and protect their health they have to spend a large percentage of their income in medical expenditures and when they have health emergencies they might need to sell their productive assets and/or borrow money from local lenders at unthinkable high interest rates. Data from India, for example, indicates that 24% of people who face a health emergency fall into poverty.

The health conditions in developing countries are becoming more complex every day. While the old communicable diseases are still widely affecting most people in developing countries and new ones such a HIV/AIDS are a constant threats, chronic diseases such as hypertension and diabetes are increasing at an alarming rate, especially among women.

None the less, chronic hunger and malnutrition are at the heart of the problem: we know that more that 50% of the deaths among children under 5 years of age are directly linked to under nutrition--even even mild degrees. More recently it has become more evident that weight gain/obesity is the strongest risk factors leading to an increase in the frequency of chronic disease.

How complex is it getting? Well, the striking reality is that you can find a malnourished child and an obese adult in the same household.

Yes, it is a real possibility but we need to go beyond the current approach. Experience has shown that health care services alone are not sustainable--the poor do no have the means to cover the costs--even minimal costs. However, when combined with another intervention such as microfinance there is a synergy that increases the impact ob both. The first increases prevention of, and prompt attention to, health problems; the second increases availability of funds to cover the cost of medical care.

By promoting the integration of health and microfinance services Freedom from Hunger is going to demonstrate and develop working models that can be replicated at a large scale. And, by focusing on the problem of chronic hunger and nutrition, Freedom from Hunger is addressing a fundamental cause (under nutrition) of ill health and death among young children and of chronic diseases (obesity)among adults. Unfortunately these two conditions coexist in many households in the developing world.

Our biggest initiative right now is to reach 3 million women by 2010. Many of the initiatives to accomplish this are already underway. For example, our Microfinance and Health Protection (MAHP) initiative is already helping our partners in five coutries to develop market-based, context-specific health protection services to improve the health and productivity of their clients and protect them financial shocks caused by health emergencies. Others initiative that you prabably have learned about today are REACH, to disseminate our services and products at a masssive scale; Microbusiness for Health to increase access to health protection productos for people in isolated rural areas; Finacial Education for the Poor to help families to better manage their financial resources; and Saving for Change to help the most remote rural poor start informa saving groups.

We do not provide services directly. We work through existing local organizations that have a strong foundation and commitmente to reduce poverty and end hunger.

There are two important reasons we do this. First, Freedom from Hunger’s most cherished value is self-help. And for us, that doesn’t just mean our support of women who are working hard to feed their families. It means that our efforts should support the efforts of local people who are fully committed to ending hunger in their own country. Freedom from Hunger has sixty years of experience in development. We know that having a group of Americans charge into a village and “teach” women what to do and how to act, doesn’t work. As soon as the Americans leave, so does the impact. A far more effective approach is to transfer our skills and knowledge to indigenous organizations—and the local people who have a wealth of cultural knowledge—so they can implement effective self-help programs. In this way, we can help create permanent resources in-country to be there for the long term—and after all, that’s our mission: to end hunger for good.

The second reason we work through partners is about leverage. Our organization is made up of just 60 people. We currently work with more than 50 partner organizations and together we’re helping about a half million women and their families. If we insisted on doing everything ourselves, our outreach would be closer to 10,000 women—if we were lucky. There are one billion people who are hungry. We’re morally bound to use strategies that reach the most people.

We ourselves are not a microfinance institution or a public health organization but we promote and support programs in these two areas because we believe that their integration will help to accomplish our goal of ending hunger for good.

The array of healht needs in devloping countries is becoming more complex. In many parts of the developing world communicable diseases such as diarrhea, respiratory infection and measles are the still the bigger killers. But chronic diseases such as hypertension and diabetes are also increasing in frequency. The critical needs are: access to effective dialogue based education to improve and protect their health; access to financial resources to cover the cost of health services; and linkages to quality and affordable health services and to health protection products such a insecticide treated mosquito nets to protect them from malaia or water treament solutions to protect them from diarrhea.
The idea is not to duplicate or compete with existing health services in the developing countries but to help people to access them and use them effectively and, also, to encourage public and private health services to increase their coverage and to work together to improve the situation.

Officially most of these countries have national health systems to provide health care for their citizens. More and more these countries are under pressure to charge for these services. However, the quality and the reliability of the services is vey low and people have little incentives to seek them or even pay for them. Given these conditions people postpone seeking health care until the last minute when the disease is severe, the treatment more expensive and the possibilities of recovery less likely. To do this they are forced to sell what ever they can and borrow at very high interest rates with very high possibility of not being able to pay back and slide into poverty. Because of this, alternative models of providing access to quality and affordable services are needed and that is what our Microfinance and Health Protection (MAHP)Initiative is involved with at the moment.

I got my MD degree in the University of San Carlos of Guatemala, my MHP from the Harvard School of Public Health and my MA in Applied Communication Research from Stanford.