Reframing power dynamics in philanthropy is easier said than done. This post is about how Preston-Werner Ventures worked intimately with a handful of sexual and reproductive health organizations in East Africa, in hopes that we might better navigate between the global North and global South with actions not words.
Context: PWV staff in 2019 went to Kampala, in Uganda, to meet with prospective grantees. We flew people in from across East Africa, conducted a three-day workshop and let the grantees decide some major family-planning funding decisions for themselves.
The idea was to explore how to make grantmaking more participatory, by involving humans on the ground doing the work of social and behavioral change. We hoped to refine approaches to securing funds as well as create community and share best practices.
Further context: Although most grantmaking is still done by program officers reading proposals written by organizations from afar, PWV wanted to try a new model by peer selection. This was before the Covid-19 global outbreak, it should be noted, but lessons learned then apply to disparities evident during the pandemic.
The workshop: Twenty-two participants attended from eleven organizations in Kenya, Uganda, Ethiopia, Burundi, Malawi and Rwanda. Three were existing PWV grantee partners, three had applied before unsuccessfully, and five were “mentor” organizations. Each sent a youth representative and one staff member. It was led by: Theresa Preston-Werner, PWV’s managing director; Lindsay Menard-Freeman, founder and CEO of the Torchlight Collective; and Amelia Abdelrazik, portfolio and impact manager at PWV.
Attendees: Mother Health International, ACCESS, Reach a Hand Uganda and the Kabubbu Development Project, from Uganda; GRADIF-K, Dandelion Africa and KMET, from Kenya; the Kindle Orphan Outreach, from Malawi; the Musanze Youth Center, from Rwanda; SaCoDe, from Burundi; and PSI Ethiopia, from Ethiopia.
Shaking up philanthropy
Ok, so, let’s face it: Wealth to offer is a place of privilege. The 1 percent of the 1 percent. Capitalism, as much we hate it when it’s oppressive and unfair and heats up the planet faster than we ever expected, brought us where we are.
We’re here, in other words. We’re trying to redistribute some of the wealth, however it may have been acquired, and learning about how to do it effectively and equitably as we go. And so we ask ourselves, as a family foundation with its roots in a startup-driven industry, how can we do this better? Isn’t there a way to operate from this advantageous place with more compassion for and insights from the people actually doing the work?
In 2019, Theresa Preston-Werner, PWV’s co-founder, sought an answer to that question. She proposed a workshop to bring together organizations working on youth family planning in East Africa that would hand them the grantmaking reins. Amelia Abdelrazik, then the portfolio and impact manager at PWV, loved the idea. Folks closer to “the problem” taking the lead came naturally given her experience working as a Peace Corps volunteer in Botswana.
Theresa brought a different background, having completed a Ph.D. in anthropology and organized non-profits in Central America to educate young women and expand access to family planning. That training preceded her experience starting companies in the tech industry.
With all that serving as their stage, Amelia and Theresa together came up with a plan that they hoped would encourage a more participatory process. They did so because money-allocation can leave those seeking the funds alienated. They wanted to hear and feel those on the other side, as well as help them to craft better presentations when asking for the funds they need to make their work happen.
The PWV attitude reflects a broader movement in philanthropic thought. While she did not invent the wheel in this respect, a recent blog post by MacKenzie Scott in which she urged the media to not focus on the $2.74 billion she has donated to 286 entities this year brought the issue more attention. Long story short, Scott doesn’t want her unprecedented charity spree to mean more focus on her; she wants it to shine a light on “people struggling against inequities,” as she stated in a recent blog post on Medium.
“Putting large donors at the center of stories on social progress is a distortion of their role,” she wrote, in an essay posted on Medium. “We are all attempting to give away a fortune that was enabled by systems in need of change. In this effort, we are governed by a humbling belief that it would be better if disproportionate wealth were not concentrated in a small number of hands, and that the solutions are best designed and implemented by others.”
And though PWV doesn’t have THAT kind of cash, we still concur. We continue to believe in raising up voices however and wherever we can.
Frontline issues: Contraception, HIV, homophobia … and now Covid
Community was the basic idea behind the Kampala workshop. How to reach it and listen to it and give representatives a clear avenue to share their work. PWV asked each attending organization to send a youth participant as well as an operational staff member, not necessarily an executive director. Executive directors and other heads of organizations often have professional development opportunities but may not be as intimately involved with the day-to-day work. Amelia in particular wanted to make sure that this workshop sidestepped the typical leader-focused event.
Organizations were focused on the core issues related to frontline family-planning problems in East Africa. Namely, older health workers who might have a bias against distributing contraception; widespread homophobia or laws against homosexuality; better training for midwives; the prevalence of HIV and misinformation about it; malaria; and how to reach young people to talk about family planning, reproductive rights or any of the above.
It was the insertion of youth into the dynamic that perhaps contributed most to the workshop’s success, according to several who attended. Amelia explained that the approach was “much different” from what such organizations were used to, and that was the point: to not follow the usual script.
“A lot of the young people had never been outside their villages or countries,” Amelia said. “Some of them have never been on a plane. I was very proud that we were able to afford them that opportunity.”
Maureen Andinda, business development manager at Reach a Hand Uganda, likewise emphasized that element of the workshop. The addition of youth was memorable to her, noting that Emmanuel Fokushaba represented adolescents from her organization and contributed feedback. Doing so “enabled us to capture some of the thoughts on the project development from their perspective,” Maureen said, in an email sent from Kampala.
“I thought that was a great show of meaningful youth participation,” she wrote. “The workshop was organized and conducted with the deliberateness of hearing from young people. I really appreciated that.”
Maureen also credited Amelia and Theresa for allowing participants to interact with them freely, saying “this took away most of the pressure that power dynamics would have put on the participants.”
“Theresa and Amelia listened and engaged with us all as much as they shared and facilitated,” Maureen said. “For me personally, this openness and easy access to Amelia especially has continued and shown that she is available to engage with us as partners. Not a lot of funding partners are easily accessible in that way.”
Increased risks abound due to Covid
The inclusion of youth representatives was seen as vital, because so much of the work in East Africa had to do with adolescent girls and young women and their access to sexual reproductive health and family planning information. Maureen said her project sites are often in hard-to-reach rural communities, some of them in refugee settlements more than 200 miles from Kampala.
Moreover, reproductive health services are often considered taboo in Uganda, so Reach a Hand Uganda works with young people to train peer educators. Maureen credits PWV for family-planning funding that was unrestricted and helped her group allocate for peer educators to travel long distances in mountainous areas, “or supporting us to acquire teaching aids that make the peer educators' learning sessions easier in their communities of practice.”
But she also cautioned that community realities on the ground often correspond with larger conflicts between the haves and have-nots. This has become more apparent during the spread of Covid-19 and Uganda’s limited access to vaccines. (Maureen’s comments about the PWV process were offered last week.)
“I think it's helpful for your audience in the United States to recognize that while the challenges we work on are mostly community-based in terms of their impact, a clear parallel can be drawn between these ‘Ugandan’ issues and the global issues such as foreign policy from the global North,” she said, pointing to the Trump administration’s so-called “Global Gag Rule” and more recently Covid-19 vaccine inequity.
Covid fallout, she warned, “has quickly shifted to another form of inequality in as far as policy and government action on vaccination stands. Access to [family planning] since the emergence of Covid has become even harder. We worry about the increased risk to our staff and peer educators and the already burdened health care system experiencing even further strain as precedence for Covid treatment has taken over.”
She added: “As long as vaccine access continues to be a matter of the haves and the have nots, ripple effects on other crucial health issues such as maternal and adolescent reproductive health will continue to suffer. Boardroom decisions go a long way to affect people thousands of miles away in very life altering ways.”
Maureen also stressed that reproductive health is the aspect of healthcare most under pressure by Covid-19. She said Uganda has seen more maternal deaths due to limited access, “and now with the delta variant, expectant mothers are at a much higher risk.”
“Access to contraceptives and HIV services has been strenuous and cases of sexual gender- based violence increased too,” she wrote. “Vaccines, to date, seem to be the best chance we all have to combat Covid. However, if vaccine access is prioritized in North America and Europe … and countries like Canada procured millions more in vaccines than their population … and yet people in the global South who are willing to get the vaccine do not have access to them, then the ripple effects to reproductive health from Covid are likely to continue as we move from one wave to another.”
Elevating the voices of folks on the ground during funding decisions is one way to begin to level the playing field. For Theresa, the idea sprang from her work at Global Fund for Women, where she sits on the board, as well as a startup mentality she can’t seem to shake. Global Fund for Women has been a significant player in advancing the practice of feminist philanthropy, to “bring more voices to the table and shift the power of grantmaking to those who don’t have the capital in the first place,” Theresa explained.
“Amelia and I were really excited about that model, that idea of trusting people who know best,” she said.
And ironically or not, Theresa isn’t necessarily the most comfortable figure when it comes to the wealth itself. She developed a few thoughts about philanthropy before she became a wealthy person, before she and her husband made a bundle at GitHub. She was a trained academic (“a Marxist,” in her words) who viewed the notion of the privileged helping the not-as-privileged as imperfect and likely to exacerbate divides between the global North and South.
“Everything that I read for my Ph.D. was critical of NGOs, critical of humanitarian aid, critical of any efforts to solve problems by people with privilege,” she said. “We always wanted to look at the root of the problem and the structural changes that needed to be made.”
But then Theresa ended up in Guatemala working for an NGO called Women Work Together, rather than in academia, and “suddenly I became an advocate for the work they were doing because I cared about the causes.” She admits she still carries skills and traits from all three of her backgrounds, meaning academic, tech and now philanthropy.
“It was 15 years studying poverty and never being able to do anything about it,” she said. “I found that was very frustrating.”
‘Some really beautiful moments’
All organizations had the opportunity to present their work to the larger group. PSI Ethiopia, for example, pitched best practices from its “Adolescents 360” initiative. Part of that program — called “Smart Start” — seeks to find and support married adolescent girls in their most vulnerable moments, to help them make better decisions, live better lives and keep the population to manageable levels. Smart Start provides counseling to girls and their husbands about contraception and family planning and therefore addressed “an unmet public health need” by going into communities and seeking girls who might otherwise be left to fend for themselves, the PSI presentation said.
Another proposal came from SaCoDe’, which loosely stands, in French, for Association pour la Santé des Communautés pour le Développement. The group came to the workshop with big plans for a “youth friendly center” in Gatumba, Burundi — the site of a civilian massacre in 2004. The presentation noted that the village has about 13,000 residents, 73 percent of whom were considered young people, at the time. The group said the residents faced significant reproductive pressures, among them HIV, sexually transmitted diseases, teenage pregnancies and non-secure abortion access.
SaCoDe’ listed the following as indicators they intended to track, if the youth center could be built: number of peer educators trained; number of condoms distributed; the average age of sexual initiation among those aged 14 to 19; and the percentage of those youths who seek counseling from their peers.
Fast forward to the end of the workshop, when each participant was given two votes on which pitch should be awarded an extra $25,000 grant (they were allowed to vote for themselves but just once). The winner was SaCoDe’.
Looking back now on the three-day workshop, Theresa sees the experiment as a success because she ran the process like a startup, “because that’s what I know how to do.”
“The goal was to give everybody the chance and the space to really think about what their communities needed,” she said, adding that the best brainstorming sessions were conducted without adult staff in the room, meaning youth participants were permitted to walk around the room crossing off ideas written on butcher paper taped to the wall.
“It was amazing when they looked at us and asked, ‘Can we really do this?’” Theresa said. “There were some really beautiful moments.”
Amelia likewise views the work as a success, because PWV was able to recognize and cede power to those working on the frontlines, now becoming its own movement in philanthropy. She called the experiment “a humbling exercise that checks your own self-importance.”
“It was a really great reminder of different kinds of expertise and what the limitations of our own knowledge can be,” she said.
We’ll give Maureen the last word, as she also was asked to assess the workshop’s impact in her universe. She stressed that she’d like influential humans in the global North to heed “the ripple effects” from policy decisions thousands of miles away, including vaccine rollouts or ending the Global Gag Rule for good.
“I’d like those in power in philanthropy to pay attention to them because they can influence, with money, networks and connections to policy, some of the outcomes of these policies,” she wrote. “They should also pay attention to them because they can continue to prioritize and channel funding to local actors on the ground who have to continuously rebuild interventions within communities when the effects of harmful policies such as these eventually land.”
Thank you for reading.
— Colin Sullivan and Amelia Abdelrazik