District 2232 is working to identify needs, connect with Rotary clubs worldwide, and support those affected by the war

Geotracking Ensures Fewer Children Are Left Behind

By Tolu Olasoji

When polio vaccinators fanned out across areas of the Republic of Congo last year to stop an outbreak, they carried a powerful new tool in their pockets: cellphones that tracked their progress as they went door to door. Equipped with a mobile app, the phones sent data back to a command center where staff could see on a digital map if homes were missed and redirect teams on the ground.

With support from the World Health Organization and other partners in the Global Polio Eradication Initiative, the country is helping pioneer the use of what is known as geospatial tracking to stop polio outbreaks. Instead of relying on hand-drawn maps that are prone to errors, response team leaders can see with pinpoint accuracy where vaccinators have been and which homes they didn’t get to. This happens in real time when a wireless connection is available. Such speed and precision are crucial to ensuring that a vaccine reaches each child and outbreaks are stopped.

“All you have to do is charge your phone and make sure you turn on the tracker when you are out on the streets. I just put it in my pocket and go from house to house,” says Sandrine Lina, one of the WHO-trained vaccinators.

She and others hit the streets in June 2023 with hundreds of the phones after an outbreak of variant poliovirus type 1. The WHO African region was certified free of wild poliovirus in 2020. But this other form of polio, known as vaccine-derived or variant poliovirus, remains a threat. These cases occur in rare instances when the live but weakened virus in oral vaccines circulates long enough through sewage in communities with low vaccination rates to mutate into a potentially dangerous form.

The key to stopping such outbreaks is a thorough vaccination campaign. Geospatial tracking is playing a crucial role, generating intelligent maps and models. “The platform provides an opportunity for us to identify settlements that have poor coverage, where we’ve not seen many tracks of vaccination teams, and we can download the information to guide processes,” says Kebba Touray, the lead of WHO’s Geographic Information Systems Centre for the African region.

An early generation of the technology was used in Nigeria beginning in 2012, helping lead to the region’s certification as free of wild poliovirus eight years later. “That’s what gave birth to this innovative idea of ensuring settlements are mapped,” Touray says. It’s also been used in Cameroon.

For the June vaccination campaign, led by the Republic of Congo’s Health Ministry, about 500 smartphones were distributed each morning to vaccinators. Like a fitness tracker, the mobile app counts steps and plots the coordinates on a map, along with essential details such as dates and times. Vaccinators also can use the phones to collect field data such as settlement names, household information, and reasons given by those refusing a vaccine.

That information feeds a database that operations center managers can supervise in real time. It’s displayed on an online dashboard through a heat map that shades areas in green and red hues. “Green indicates that vaccinators have passed in these areas, and red areas indicate that, Oh, these areas were planned, but no team passed through,” explains Derrick Demeveng, a data and geographic information systems analyst who worked with the vaccination response team.

At the end of the first day, the operations center team in the capital, Brazzaville, saw that a section of the city’s Poto-Poto district had not been covered. Vaccinators were sent there first thing in the morning to find any children who had been missed.

That ability to review data and make quick course corrections is critical. In the past, planners had to rely on maps drawn by vaccinators to prepare what are known as microplans. Inaccuracies were inevitable, and information often wasn’t verified until after the campaign had ended. “The microplan is the critical component in preparing for outbreak response campaigns. You have to know where all the settlements are,” Touray says.

Disease mapping in response to public health emergencies has a long history. In 1854, English physician John Snow pioneered one of the earliest uses of mapping in modern epidemiology during a cholera outbreak in London. In search of a pattern, Snow mapped cases and — because he believed contaminated water was to blame — the locations of water pumps, and he found a connection. He was able to identify a single pump as the likely primary source, and when it was closed the outbreak ended.

Today, with a lot of computing power behind it, geospatial analytics is used in everything from weather modeling and sales trend forecasting to national defense, disaster response, and agriculture. The WHO is using geospatial technology to counter public health threats across the globe, from saving people in India from snake bite deaths to COVID-19 vaccine delivery in over 90 countries to polio eradication.

Geospatial technology is important for reaching members of communities who are often overlooked, says Rufaro Samanga, an epidemiologist who works at the Bill & Melinda Gates Foundation, another GPEI partner. “Immunizations would be better served, especially in low- to middle-income countries, where you’re already dealing with limited resources in some settings. Real-time data from these tracking systems allows us to identify parts of the population that are often missed,” Samanga says.

The newest version of the technology, used in the Republic of Congo, has many improvements. “This one is lightweight, it’s easy to deploy,” Touray explains. “And you are able to collect field information, especially concerning settlements, and to ensure that whatever information you are able to collect during an outbreak response campaign, you go back and use it to update your microplan” for future campaigns.

Demeveng says the technology solves the challenge of on-field visibility and incorporates a system of accountability, with supervisors able to monitor, direct, and advise vaccinators in the field. When they return to the emergency operations center, an analysis of the day’s outing is carried out.

While the Republic of Congo project was deemed successful, it did brush up against a familiar challenge: the digital divide. Despite advancements in digital inclusion, 2.6 billion people around the world remain unconnected to the internet, a considerable share of them in Africa, according to one recent analysis.

And a lack of strong internet infrastructure often disrupted the real-time upload feature of the geospatial tracking app. But the technology and the data collection are filling in the picture of polio and other public health challenges.

Touray and his WHO African team plan to implement these tracking systems elsewhere on the continent, including for purposes beyond polio. With the introduction of new technologies, though, one thing hasn’t changed: All vaccinated children are still marked on a finger with ink they can proudly display.

This story originally appeared in the March 2024 issue of Rotary magazine.

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Podcast: The flight to end polio

The value of vigilance in fighting polio

Polio survivor reflects on life’s pains and pleasures

By JP Swenson

Gethen is in the midst of an ice age. It’s a bitterly cold planet where even the warmest summer day is frigid. This is where Florence Maher spent her childhood. Figuratively speaking, of course. Gethen exists only in the tales of Ursula K. Le Guin, predominantly in her 1969 novel, The Left Hand of Darkness, one of many speculative works of fiction that Maher grew up reading.

“A lot of science fiction looks at social issues, but in a different context,” Maher says. “It allows you to ask big questions about how the world would be different if things had evolved in a different way. I’m very interested in those sorts of structural issues and how they look in practice.”

As an adult, Maher continues to ask those big questions as she looks for ways to maximize her knowledge and skills by pairing them with global institutions. Today, this Rotary Peace Fellow works as a social scientist for the Organisation for Economic Cooperation and Development, gathering data and forming policy recommendations to achieve more diversity in the nuclear energy sector on a global scale.

Growing up, rural Oregon (on planet Earth) was home base for Maher, but her father’s work took the family all over the Pacific Northwest, including Alaska. However, one move took them to Berlin for two years soon after the reunification of Germany in the 1990s. “That was the moment I realized there’s a bigger world out there,” she says. “That experience started me down an international career path.”

Maher spent two years at Earlham College in Indiana (where the undergraduate student population totaled about 1,100) before taking time off to backpack around India and work as an au pair in Germany. “By the time I had finished scratching that itch, I realized I was not going back to Indiana,” she says. “I wanted to do something different.”

Although she was interested in the world, she didn’t know a lot about her own country. She wanted to put herself in situations where she could grow, she said, and she completed her last two years of studies at Howard University, a historically Black college in Washington, D.C., to learn more about diversity in the United States. Being a white student at Howard, she tried to be respectful of the history and traditions in that welcoming environment, to learn without being the “center of attention,” she says. “As a white person, this is not my space. I’m here to shut up and listen.”

Maher graduated from Howard in 2009 and, following a lengthy, intimidating, and competitive hiring process, eventually landed a job as a foreign service officer with the U.S. Department of State. “At the time, it was definitely my dream job to live around the world and represent our government overseas,” she says.

Maher was assigned to consular duties in Mexico, where she conducted visa interviews. The work drained Maher emotionally as, contrary to her own impulses, she often had to deny people entry into the United States under the law. “You may feel different personally, but you’re not there to give your personal opinion about how the world works,” she says. “You’re there to interpret U.S. immigration law.”

In 2018, Florence Maher addresses an audience that includes her classmates at International Christian University in Tokyo. A year later, she takes a break during an applied field experience in France.
Courtesy of Florence Maher

Maher was then sent to Italy as an economic officer and vice consul before relocating to Washington, D.C., in 2018. That’s when she realized that this may have been the dream job of her 20s, but not of her life. She applied for and received a Rotary Peace Fellowship at International Christian University in Tokyo. “I needed time to explore and find myself,” she says. “I wanted two years to take classes, have professional experiences, and perform field research. ICU has a very strong emphasis on doing a research-based thesis, and I was able to do field interviews and really develop my research skills to complement my practitioner skills.”

Specifically, Maher examined an attempt to develop a national action plan on business and human rights in Mexico. The endeavor, conducted between 2015 and 2018 by representatives from the government, business, and civil society, was ultimately unsuccessful in building a coalition. Nonetheless, in her 50,000-word thesis, Maher researched how Mexico’s attempt to create the plan offered a framework through which long-standing structural grievances might be better understood and more equitable social structures erected in their place.

Maher graduated from ICU with her master’s in peace studies in 2020. Now, at the Organisation for Economic Cooperation and Development, she believes she has found that sweet spot where academic theory can find practical application — and where her individual aspirations, paired with her well-honed skills, can have their greatest impact. “In June,” she says, “our member countries passed an international policy instrument to improve representation of women in our nuclear sectors. There’s a well-established body of research showing that diverse teams perform better in innovation and performance,” which could offer significant benefits to combating climate change. More women in the nuclear sector, Maher adds, could also help garner trust in and support for nuclear technology, closing the gap between how it’s perceived and its real potential.

Some of the research supporting these conclusions was provided by Maher. “I don’t know if I would have been successful with the data collection if I hadn’t been a peace fellow,” she says. “Having done a robust, research-based thesis, I had the confidence to gather the data and write the report.”

Last year, Maher was elected to the board of the Rotary Peace Fellow Alumni Association. “The identity of being a peace fellow has been very powerful,” she says. “It tells the world that you are aligning yourself with certain values — of trying to work on structural change, of trying to make the world a better place.”

This story originally appeared in the February 2024 issue of Rotary magazine.

Why so many people are still dying of cervical cancer, and what Rotary is doing about it

Women diagnosed with cervical cancer are almost twice as likely to die than those diagnosed with breast cancer. Yet cervical cancer is a disease that is preventable and treatable. What’s going on?

About 90 percent of the women killed by cervical cancer — more than 340,000 in 2020 — live in low- and middle-income countries, where access to prevention, screening, and treatment is severely limited. And reproductive care remains a taboo topic, even when it means people are dying as a result.

• 116

  Global grants awarded to fund cervical cancer projects since 2014

• 91%

  Share of cervical cancer deaths in low- and middle-income countries, where access to prevention, screening, and treatment is severely limited

• 604,127

  Number of people diagnosed with cervical cancer in 2020

The Rotary Foundation has awarded more than $10.3 million in global grant funding for cervical cancer projects since 2014, and other Rotary projects, such as an initiative in Alabama, have tackled this issue outside of global grant funding. In addition, $2 million was awarded to United to End Cervical Cancer in Egypt as part of the third annual Programs of Scale competition. The Foundation awards these grants to evidence-based programs that align with at least one of Rotary’s causes and are ready for expansion to create larger-scale change.

The four-year program in and around Cairo will vaccinate more than 30,000 girls ages 9 to 15 to prevent infection with the human papillomavirus, which causes the disease. It will provide cancer screenings for 10,000 women — allowing for early detection and treatment — and launch a public awareness campaign to reach 4 million people, helping address cultural misconceptions that may deter people from seeking care.

For Cervical Cancer Awareness Month in January, we examined the state of the disease around the world, and what Rotary members are doing about it.

Your Foundation money at work

Countries and geographical areas where global grants have funded cervical cancer projects in the past 10 years.

How HPV infection can lead to cervical cancer

Cervical cancer is primarily caused by the human papillomavirus, a group of more than 200 related viruses, some of which are sexually transmitted. Nearly all sexually active people will be infected with HPV at some point in their lives; most of these infections are harmless, but some high-risk HPV viruses can progress to cancer. HPV vaccinations before a young person becomes sexually active can prevent infection, and therefore cervical cancer. The cancer develops slowly, with five to 20 years between the first cellular changes to the actual development of cancer. Screening for abnormal cells and treatment when necessary can stop the disease from progressing and save lives.

This story originally appeared in the January 2024 issue of Rotary magazine.

With suicides rising in the U.S., Rotary members who’ve lost loved ones are determined to prevent more deaths. Their first step — talking.

By Neil Steinberg    Photography by Liz Moskowitz

The six Mardi Gras-style beaded necklaces that Lori Crider is wearing tell you something about her struggles and her hopes, if you learn the strands’ color code.

Purple honors a friend or relative who died by suicide. Crider wears four, including one for her nephew, Jesse Cedillo.

“I’ve lost three relatives, unfortunately,” she says at a fall 2022 suicide prevention walk that starts at a former MLB stadium outside Dallas with rain clouds framing the roller coasters nearby at Six Flags Over Texas. “I had an aunt in the ’90s, then my cousin in West Virginia after Jesse. I wear a purple for each of them and for a friend who took his life in 2005.”

Blue is for suicide prevention, an issue that has become a calling for Crider and fellow members of a Rotary club created in 2021 to take action on that cause, as well as for many people at the walk whose friends or family members died by suicide.

Crider’s nephew, whom she describes as a soft-spoken young man who dreamed of becoming a police officer, died at 20 years old in 2015 using a gun he got from a relative’s house next to his home in rural Alabama. Family members say they always had guns available for protection and for shooting sports through 4-H.

Nearly 50,000 people die by suicide each year in the U.S., and over half of them use a gun. The total number of annual suicide deaths is equivalent to filling the seats of the one-time MLB stadium where the Dallas-area walk took place. In 2022, preliminary figures indicate that the rate of suicide in the U.S. was the highest in the five decades since the U.S. Centers for Disease Control and Prevention began recording that data. The negative effects of the COVID-19 pandemic may have contributed to the increase, according to a CDC report. Globally, more than 700,000 people die by suicide each year, according to the World Health Organization.

While there is no simple solution to preventing suicide, a proven precaution is limiting access to items or places that people in crisis could use to harm themselves. “Putting time and space between a person and a lethal method of suicide can save lives,” says Marian Betz, an emergency room doctor and University of Colorado professor who researches suicide and firearm death prevention.

This is the idea behind blister packages for medicines and barriers added to bridges. With firearms, having access to a gun triples the risk of suicide, in part because guns are so much more deadly than other ways people try to die, Betz notes in a video message that she recorded as part of her work with the American Foundation for Suicide Prevention. Nearly 90 percent of firearm suicide attempts in the U.S. result in death, while only 2 percent of intentional drug overdoses do. And some studies indicate that many people who try to end their lives act rashly with little planning.

Guns rob many people of a second chance to live, Betz says. “When we’re talking about suicide prevention and firearm suicide prevention, we’re not talking about gun confiscation. We’re talking about ways to lock it up more securely during a time of risk,” she says.

After her nephew’s death, Crider, a Rotary member since 2010, threw herself into helping others and worked with Shirley Weddle, also a loss survivor and mental health advocate, to establish the Rotary E-Club of Suicide Prevention and Brain Health. Its members encourage others to talk and think about how every person can contribute to reducing suicides in the U.S. and around the world by making mental wellness a routine part of day-to-day life. Club members regularly participate in events that promote awareness, eliminate stigma, and support survivors, including the Out of the Darkness Walks like the one outside Dallas, which the American Foundation for Suicide Prevention organizes.

The focus of the e-club, which started with about 50 members — most new to Rotary — is an example of how Rotary is at the forefront of encouraging people to tend to their own mental health and check on the feelings of those they encounter — openly and warmly. No stigma. Rotary President Gordon McInally is encouraging members worldwide to up their mental health efforts because of his personal commitment to the issue after his brother died by suicide.

Though programs to address suicide can vary from culture to culture, Rotary clubs around the world are supporting the work of mental health providers in their areas and taking other actions. The Rotaract clubs of Sahel Metn in Lebanon and Amsterdam Nachtwacht International raised money to support the only suicide hotline in Lebanon. Rotarians in Nepal led a session for teachers on suicide prevention and mental health management in schools, including ways to reduce stigma and discrimination.

A club outside Manila in the Philippines organized free counseling for seniors. And clubs in the U.S. have held education sessions about suicide prevention and ideas to reduce access to potentially dangerous items and locations when people are at greater risk of self-harm.

When e-club members collaborate with organizations and talk to Rotary clubs or community groups about ways to prevent suicide and improve mental health, their presentations cover topics including risk factors, warning signs, intervention, and ways to separate lethal objects and people thinking about suicide.

Betz advises doctors to educate their patients who are around guns about their options when they or someone they’re close to is at risk of harming themselves. Public health experts suggest that people store guns unloaded and away from the ammunition with a cable lock or in a safe. Or move them out of the home when someone is in crisis; some gun stores and law enforcement agencies will store them temporarily. And other people choose not to own one when there is a suicide risk, Betz notes.

Crider echoes the idea that the safer the environment is made for a suicidal person by temporarily reducing access to lethal items, the better the person’s chances are of coming through a crisis period. “We give them time for the intense suicidal impulse to diminish and time for someone to intervene with mental health support,” she says in a presentation called Talk Saves Lives that she gives to Rotary clubs. She and Weddle, the e-club’s charter president, along with member Terri Hartman, became presenters of the talk developed by the American Foundation for Suicide Prevention, starting with clubs in their district with a goal to spread awareness and wellness ideas across the world. The three connected in a grief support group and now lead support groups for survivors of suicide loss.

A hopeful takeaway from the presentations, fundraising events, and awareness campaigns is that mental wellness advocates and public health experts have some ideas to try to help. They want everyone to hear them — whether a person thinks about dying themselves, knows someone who struggles with suicidal thoughts, or just wants to do their part to make the world more supportive of people who need help for depression, traumatic stress, loneliness, substance use, and other strains in life.

To start, mental health experts want people to throw out any hesitation they feel about talking with a friend, parent, sibling, or child who they suspect might be thinking about dying or harming themselves. The National Alliance on Mental Illness notes that many studies show that discussing the issue doesn’t increase the chance of suicide.

And experts emphasize you don’t need to have all the answers. Often people in distress aren’t looking for concrete advice, and just making small talk and showing empathy can save lives, according to the International Association for Suicide Prevention. The group advises to watch for warning signs, including hopelessness, rage, and reckless activity, and to be knowledgeable about available resources.

Crider suggests that people in the U.S. make the 988 Suicide & Crisis Lifeline a contact in their phones. “You might need it for yourself or for somebody else,” she urges. “Reaching out is not a sign of weakness; it’s a strength.” And counselors and doctors recommend that people with suicidal or self-harm thoughts create written safety plans that spell out in detail what they’ll do, whom they’ll contact, and even what they’ll tell themselves when those thoughts start or when they feel out of control. One step in those plans is to secure or get rid of any items that the person could use to harm themselves.

The value of connection cannot be overstated. “Let them know they are not alone” is one piece of advice Crider shares. “Our family decided our thing was to talk about it, because nobody saw it coming,” she says.

At the walk outside Dallas, a steady stream of people moves out into the rainy morning, a long, snaking line on the sidewalk knotted with groups of friends and relatives, some holding large photo montages of loved ones who died or wearing matching tribute T-shirts: “Team Jake” and “#ForJames” and “#TeamJulian,” honoring an 11-year-old. Many of their stories echo a recurrent theme: the presence of a gun turning a passing impulse into a permanent loss.

Crider hopes the march will open the gates for families to speak about suicide and how to stop it — families like Kathy and Tony Thompson, who attended the walk. They lost their 18-year-old son, Luke, to suicide in 2018. Kathy Thompson could barely speak at her son’s memorial. But now she and her husband talk about it to others, one-on-one, and have seen results.

Several months after Luke’s death, Tony Thompson felt compelled to share his family’s story with a coworker, who talked to his own family about it. “His daughter went to school the next day and told a counselor, ‘I haven’t been sleeping the past two days. I have this plan ...’ There was a huge intervention,” Thompson recalls.

“Her mother called me and said, ‘I think you guys saved my daughter’s life,’” Kathy Thompson says. They learned that the daughter had been planning to take her life and hadn’t shared her feelings with her parents because she didn’t want to worry them. The Thompsons became close with the couple, who told them that hearing their story had enabled their daughter to open up. “Later, she was crying at her high school graduation party, saying, ‘I wouldn’t have been here,’” Tony Thompson says.

Other walkers wearing beaded necklaces in red for the loss of a spouse or partner, gold for a parent, greet each other and take literature and snacks from information tables at the stadium. The e-club is one of the sponsors of this walk, which is aimed at educating the public and allowing those with a connection to the cause to come together. The event raises money to support research, advocacy, and education.

Crider also has a necklace in teal in support of someone who attempted suicide. She took up the cause of suicide prevention as a way to cope with the grief she felt after her nephew’s death and try to prevent further deaths. “I hope I can help someone else from losing their Jesse,” she says.

In the stadium, Weddle sets up a table for the e-club with bowls of awareness wristbands and red-and-white mints, plus handouts describing the services and training offered by club members and mental health organizations they represent. She wears white beads in remembrance of a child. She lost her only child, Matthew, to suicide when he was a 22-year-old student at the University of Texas at Dallas. The e-club has recently sponsored suicide prevention awareness walks at the college.

To Weddle, an important aspect of the walks is to publicly demonstrate that suicide is not a taboo topic. “You not only can talk about suicide, you must,” she says. People’s perceptions begin to change and stigma decreases when they approach mental health as physical health and understand how sleep, diet, exercise, and stress affect the body’s chemistry and people’s actions and reactions, including thoughts of suicide, Weddle says.

The e-club’s display is among a variety of tables from groups at the walk. One table is for Soldiers’ Angels, an organization that provides support and resources to military service members, veterans, and their families.

About 17 U.S. military veterans die by suicide every day, a rate nearly 60 percent higher than that of other U.S. adults, even after adjusting for age and sex differences. Risk factors for veterans include physical and mental conditions stemming from their service, difficulties transitioning to civilian life, and access to firearms at home.

At a table promoting gun storage ideas from the Be Smart advocacy group, volunteer Donna Schmidt says the organization uses the word “smart” as an acronym to remind people about five steps they can take: secure all guns in your home and vehicles, model responsible behavior, ask if there are unsecured firearms at other homes, recognize the role of guns in suicide, and tell others about these tips. Its volunteers have spoken at Rotary club meetings around the country. Schmidt says their message is: “If you have one, then please be safe.” Free cable locks are available at the event.

The walk is brief, a little over a mile, but long enough to raise $227,532. Its nonmonetary value is obvious to the participants: gather, walk, talk, hug, cry.

Those who tend to the needs of people at risk or who live with the aftermath of a suicide also learn to look out for their own health and mental well-being. E-club members share self-care ideas at their meetings. For Crider, part of her self-care is to always keep moving. She looks up at the sky and counts even the rain on the Out of the Darkness Walk as a blessing.

“It’s such a big issue, it really needs more attention,” she says. “We need to talk about these things, to bring knowledge to more people. We’ve got to bring it out of the darkness and talk about where people can get help.”

Neil Steinberg is a news columnist on staff at the Chicago Sun-Times. His book, Every Goddamn Day: A Highly Selective, Definitely Opinionated, and Alternatingly Humorous and Heartbreaking Historical Tour of Chicago, was published in 2022 by the University of Chicago Press.

This story originally appeared in the November 2023 issue of Rotary magazine

Rotary and Habitat bring rooftop solar to low-income homeowners

By Amy Hoak

The Habitat for Humanity home that Amber Cox moved into in 2020 not only provided a new, comfortable living situation for her and her son — it also helped keep the family's energy bills low.

That's because their duplex in Virginia's Shenandoah Valley came with a perk: rooftop solar panels, installed shortly after she moved in. The technology produces enough energy to greatly reduce her electric bill and create wiggle room in her budget. "It pretty much covers what would be my electric bill about three quarters of the year," Cox says.

Even in the wintertime, when the heat is running and sunlight is less abundant, she saves about $40 a month. This, in turn, makes it easier for her to spend on activities for her 9-year-old son, like registration fees for the swim team or a weekend trip to the zoo. Among residents of affordable housing, she's one of the fortunate few with solar power.

While the cost of solar panels has plummeted, the technology has not reached everyone equally. Low-income families, which stand to benefit the most from the savings, are among those with the least access to renewable energy. Barriers include high upfront costs, difficulty accessing loans, and disqualification for tax credits.

Environmental justice advocates in the U.S. have pointed to the disparity as an example of how people of color, who often endure more pollution in their neighborhoods, higher rates of asthma, and some of the greatest impacts of climate change, are also shut off from climate solutions. The civil rights group NAACP is among those pressing for greater access to solar power in communities with large percentages of Black or Hispanic residents.

Through their service partnership, Rotary International and Habitat for Humanity International are trying to shrink that solar equity gap, an effort that can have a lasting impact on families and communities. Habitat is a global nonprofit that improves living conditions in more than 70 countries, including by removing hurdles to affordable, adequate housing for families.

"There's such a thing as energy poverty," explains Liz Henke, of the Rotary Club of East Chapel Hill, North Carolina. "The energy bill is such a high percentage of disposable income for low-income people. If you can help decrease that power bill, you can help interrupt that cycle of poverty. It means families can afford shoes, buy better quality food, and all that goes back into the economy."

Since 2020, Henke's club has helped the local Habitat affiliate raise more than $330,000 for solar panels. She recruited a student intern who helped solicit the donation of 100 solar panels from Strata Clean Energy in Durham, North Carolina.

As a member of the Environmental Sustainability Rotary Action Group's Renewable Energy Task Force, Henke also helped produce a guidebook, with support from Habitat and Rotary, to advise other clubs in the U.S. how to make solar a reality for low-income homeowners in their locations. The ESRAG guide educates readers on the basics: Rooftop solar uses photovoltaic panels to convert sun rays to electricity, cutting the expense of drawing power from a utility. And power companies pay homeowners for energy that isn't used and is fed back into the grid, which can further offset monthly electric bills. The installation of a 5.4-kilowatt solar system can save a homeowner $50 to $150 a month in electricity costs. The guidebook also covers practical topics including tax credits and rebates, grants, fundraising, and donations of equipment, labor, and expertise.

Because of the high upfront investment, Habitat affiliates have had to navigate a patchwork of funding sources, which tend to shift and fluctuate over time, says Beth Wade, director of land acquisition and project development for Habitat of Cape Cod, Massachusetts. The partnership with Rotary could help, she says. "This [partnership] has the potential to stabilize funding because it may provide a new group and a new pool that we can go to when there aren't state funds," Wade says. "We live right in liberal Massachusetts, progressive Massachusetts. And even here, the funding ebbs and flows."

Already, there are Rotary/Habitat solar projects being pursued in places including upstate New York, Delaware, Minnesota, Virginia, Massachusetts, Georgia, North Carolina, Ontario, and Côte d'Ivoire, Henke says.

"It used to be, if you're going to put solar on a house, you really needed to be a tree-hugger, you needed to be willing to actually pay a premium for energy that was zero carbon," says John E.P. Morrison, executive director of NC Clean Future, an initiative that promotes clean energy, air, and water and land preservation in North Carolina. Today, once the system is in place, maintenance costs are minimal and the electricity is almost free — as long as you can pay for the system upfront, he adds.

The full cost of residential rooftop solar, including installation, dropped 64 percent between 2010 and 2022, according to the National Renewable Energy Laboratory, part of the Department of Energy. But many tax breaks helping bring down costs favor higher earners. Homeowners with lower incomes often don't pay enough in taxes to benefit from the rebates.

But a law approved last year allows non-taxpaying entities to get the same 30 percent rebate on solar installations as taxpayers, Henke says, so organizations like Habitat can direct the savings to the homeowners. It's a way to begin to bring equity to solar energy.

"We're significantly reducing the energy burden of these families. We're contributing to the generational wealth of these families," says Jeff Heie, director of GiveSolar, a nonprofit organization that helps other nonprofits and homeowners with lower incomes gain access to solar energy. Homeowners can save an estimated $25,000 over the life of a solar system, he says.

Heie and others hope that putting solar on Habitat homes could have a ripple effect on the homebuilding industry, with more developers equipping homes with the technology. The Habitat project shows that if it can be done for low-income homeowners, anyone can do it, he says.

To reap the full benefits of solar power, it's best to plan for an installation when the home is built. Homes need to be oriented for direct sunlight, and in the Northern Hemisphere the roof plane should face southward for maximum exposure. Building the homes with the proper electrical infrastructure is also helpful. "Most houses don't have electrical wires running up to the roof," Morrison says. "It's much easier to put that wiring in when the house is being built, as opposed to try to retrofit it later."

An expansion of rooftop solar is also an important path to meeting climate goals. The impact of one 5.4-kilowatt rooftop solar system is the equivalent of planting 3,000 trees or not driving about 300,000 miles, according to the ESRAG guidebook. "Rotary members, for the environment, like to plant trees. If we plant 50 trees on a Saturday morning, we've worked really hard," Henke says. "If you put up solar panels, that's the equivalent of planting thousands of trees that do not need to be tended, watered, or mulched."

Amber Cox is encouraged that more people are getting access to solar energy. "Once upon a time, the only people that could afford solar maybe didn't have the same amount of need that we do," Cox says. "We've come so far with solar. It does make for a hopeful future."

This story originally appeared in the September 2023 issue of Rotary magazine.

Gregory Rockson

• PPIA Junior Summer Institute Fellow, Princeton School of Public and International Affairs, 2011 
• Rotary Ambassadorial Scholar, University of Copenhagen, 2011-12 
• Bachelor’s in political science, Westminster College, 2012

Turkey and Syria were struck by a devastating earthquake on 6 February that has killed tens of thousands of people, destroyed thousands of homes and other structures, and left people across the region without shelter in bitterly cold winter weather. While still providing aid to those impacted by the first earthquake, another 6.4 magnitude earthquake occured in the same area on 20 February, bringing even more devastation. 

By Bob Aitken

Here are seven reasons you’ll want to attend the 2023 Rotary International Convention in Melbourne.

1.  

   You’ll (re)connect with the Rotary family.

   The last Rotary International Convention, in Houston, was proof there’s nothing like connecting face to face. But for many Rotary members in the Asia-Pacific region, where COVID-19 restrictions complicated travel plans, Melbourne will be their first in-person convention in four years. With five districts (representing more than 250 Rotary and Rotaract clubs) across the state of Victoria hosting the event, it’s sure to be a big reunion.

    

2.  

   You’ll explore the world — all in one place.

   The convention is the best way to appreciate Rotary’s global scale and reach, says Rebecca Fry, founding chair of RYLA (Rotary Youth Leadership Awards) Oceania and charter president of the Rotary Club of Social Impact Network, New South Wales. “The House of Friendship is a true festival of Rotary, showcasing our organization’s fellowships, action groups, and community projects from around the world.”

    

3.  

   You’ll discover cities within a city.

   The coastal metropolis is known as the Australian capital of culture, food, sports, architecture, and theater. It’s also a shopping mecca.

   Mary Barry, chair of the Host Organization Committee, proudly notes Melbourne’s regular recognition as one of the world’s most livable cities. It is a family friendly place where visitors will feel instantly welcomed and at ease. “The city looks after its tourists with excellent public transport to unique attractions,” says Roslyn Teirney, an assistant Rotary public image coordinator for Zone 8 and a member of the Rotary Club of North Hobart, Tasmania.

    

4.  

   You’ll be inspired.

   Rotary conventions are all about an exchange of ideas. And each year’s gathering brings you big name speakers to inspire, connect, and spur solutions to the world’s toughest challenges. Just look at the list of some past speakers: Bill Gates, Justin Trudeau, Mikhail Gorbachev, and Princess Anne of the United Kingdom. “While still early to announce 2023 program highlights, be assured only outstanding international speakers will take part,” says HOC Chair Barry.

    

5.  

   You’ll get your kangaroo fix.

   Experience quintessential Australia with a visit to the Melbourne Zoo for a close-up and safe encounter with some of the world’s most unusual, cute, and dangerous species — kangaroos, koalas, snakes, spiders, crocodiles, wombats, and platypuses. Just 13 miles northeast of Melbourne’s central business district, the Gresswell Forest nature reserve provides spectacular sightings of eastern gray kangaroos, says Jennifer Scott, a past district governor and member of the Rotary Club of Central Blue Mountains.

   Need more cuteness? Head to Phillip Island, 75 miles southeast of Melbourne, and check out the largest colony of little penguins in the world.

    

6.  

   You’ll feel energized.

   Looking for a place to hang out with all your new Rotary friends once the day is over? Melbourne has endless options. Laura Telford, chair of the Rotaract Australia multidistrict information organization and member of the Rotaract Club of Canberra, describes Melbourne as another of the famous cities that “never sleep.”

   “Visitors will enjoy jumping on one of more than 475 trams that cover 250 kilometers [155 miles] of track to take you to every corner of this exciting city.”

    

7.  

   You’ll want to see more of Australia.

   While the distance can be a challenge in traveling to Melbourne, visitors may fly in to Sydney, Brisbane, Darwin, or Perth to make the most of a unique travel opportunity by seeing other parts of Australia. “The Great Barrier Reef, Uluru and the Red Centre, our tropical north, and the rugged coast of Western Australia all present memorable sightseeing experiences,” Scott says.

    

For more ideas, visit melbournecb.com.au/welcome-to-melbourne.

This story originally appeared in the December 2022 issue of Rotary magazine.

A Multiyear Medical Mission in Moldova Adapts to a Pandemic — and a War

By Geoffrey Johnson

In December 1999, Stephen Mackler was on a medical mission to Bucharest, the capital of Romania. As he completed his work there, a colleague pulled him aside.

“Steve,” he said, “I need you to go with me to Moldova.”

“Great,” replied Mackler. “Where is Moldova?”

Moldova, of course, is the Eastern European country and former Soviet republic situated between Romania and Ukraine. Mackler’s visit there would lead to a series of Rotary Foundation global grants and significant improvements to Moldova’s outmoded nursing program — and this endeavor would continue despite the global pandemic and the outbreak of war.

But first, back to 1999. While in Moldova, Mackler visited several hospitals, and he returned to his home in the U.S. distressed at what he’d seen, especially the number of people suffering from illness related to the Chernobyl nuclear disaster. Fortunately, Mackler, a periodontist and adjunct professor at the University of North Carolina’s school of dentistry, was also a member of Rotary. He had joined the Rotary Club of Guilford (Greensboro) in 1995 after an earlier medical mission — this one to the jungles of Brazil — where he’d seen Rotary in action. So he knew exactly where to turn.

Mackler reached out to a fellow Rotarian who told him about a recently formed partnership between Moldova and the state of North Carolina. The partnership was the outgrowth of a program, originally military in nature, promoted by the U.S. Department of Defense to encourage cooperation among U.S. states and the former Soviet republics. Mackler met with Elaine Marshall, North Carolina’s secretary of state (Marshall continues to hold that office today and remains a champion of the Moldova-N.C. partnership), and in 2000 he traveled to Moldova to provide dental care. “We’ve been coming back year after year,” he says, “and we’ve been doing the things [Moldova’s health care leaders] wanted us to do. So we were building a lot of trust, which is the first thing that we had to do.”

As the years passed, Mackler recruited other dental professionals, as well as some of his students, to accompany him on those trips, which were supported in part by contributions from his Rotary club. Often those recruitments took place at his North Carolina practice, and in 2006, a nurse landed in his dental chair. Before long she too became a member of Mackler’s traveling team and began enlisting other nurses who might help modernize another aspect of Moldova’s medical system.

“Moldova had nursing colleges that young women and some men attended right out of high school,” explains Mackler. “But they were more like nurse assistants, doing things like changing bedpans.” What’s more, Moldova lacked the regulatory standards applied to nurses in most developed countries.

Mackler and his volunteer team of medical professionals set out to rectify that. Once again, he got help from his Guilford (Greensboro) club, as well as from District 7690 (North Carolina), which provided district grant funding. Working with the Nursing Association of the Republic of Moldova, the team sought to develop a core curriculum in professional nursing for the Nicolae Testemițanu State University of Medicine and Pharmacy in Moldova’s capital, Chișinău. The Rotary Foundation provided the project its first global grant in 2015, with the Rotary Club of Chișinău Cosmopolitan serving as the host club and the Guilford (Greensboro) club as the international partner; in the three global grants that followed, the Rotary Club of Chișinău Centru served as host.

As the project expanded and evolved, Mackler concentrated on fundraising and assembling the right personnel. Eventually he ceded the lead role on medical matters to a 15-member vocational training team known today as the North Carolina-Moldova Nursing Collaborative. As Mackler recalls: “I told my wife, ‘You know, I’m not used to working with nurses.’ She said, ‘Steve, keep your mouth shut, and they’ll take charge, which is what nurses do.’ And that’s exactly what they have done.”

The training team includes medical professionals and educators from several schools in North Carolina. Among them are three key players with ties to the University of North Carolina at Greensboro: team leader Deborah Lekan, a recently retired assistant professor of nursing; Audrey Snyder, a professor and the associate dean for experiential learning and innovation; and Nancy Hoffart, the recently retired Forsyth Medical Center distinguished professor who is the project director on the collaborative’s latest global grant. “In describing these women, I use the words ‘committed’ and ‘dynamic,’” says Mackler. “They’re doing this on their free time, and it’s unbelievable the amount of time that they’re spending on this.”

“Thanks to the partnership, we were able to have higher studies for the training of nurses at the university level and obtaining licensed nurses,” says Elena Stempovskaia, the president of the Moldova nursing association. “Nurses can also continue their studies toward masters and doctoral degrees. All these activities contributed to the development of the nursing profession and the improvement of the quality of care provided by nurses.”

Two years ago, after reevaluating its strategies and goals, the nursing collaborative began laying the groundwork for what would become its fourth and largest global grant: a $197,400 bequest made possible in part by $150,000 in gifts to The Rotary Foundation presented by Guilford (Greensboro) club member Eugene Parker, and his wife, Margaret.

At the same time, the collaborative planned to continue the exchange of visits between the two countries that, beginning in 2014, had provided delegations of nurses and other medical professionals the opportunity to teach and learn together in person. The last exchange occurred three years ago when the North Carolina team traveled to Moldova, followed by a visit in which Moldovan doctors saw U.S. nurses at work. After that session, the doctors “were bubbling,” says Hoffart. “They began to see that having better-educated nurses with more autonomy and a broader scope of practice could help them as physicians and improve the services they were offering patients. So that was a really cool visit.”

It was also the last visit, as COVID-19 halted the in-person exchanges. The educational outreach, however, continued. In North Carolina, nursing collaborative members produced digital slide presentations and webinars that provided their Eastern European counterparts with information about dealing with the pandemic — and, when translated into Romanian (Moldova’s official language) and Russian, the slides and videos could be distributed to a wider audience than the personal exchanges had allowed.

“The webinars organized during the pandemic gave us the best lessons on how to [respond to COVID],” says Stempovskaia. “We had six webinars at the national level, in which up to 600 nurses participated each time. But since the webinars were recorded, we transmitted them to every medical institution in the country, where every nurse had the opportunity to participate.”

The webinar approach also proved effective when war broke out in Ukraine and refugees began flooding into Moldova. “We were able to turn on a dime and redirect our [efforts] to something that met the immediate need for education,” says Hoffart.

“The war in Ukraine led to a large number of complicated situations that nurses in Moldova had not encountered before,” says Stempovskaia. “Together with our colleagues from North Carolina, we picked the important topics and organized 10 webinars that were also recorded and placed on YouTube, web pages, and Facebook,” further extending their reach.

“The global grants had had a great impact, especially during the pandemic and now during the war in Ukraine,” adds Irina Rusanovschi, a member of the Rotary Club of Chișinău Centru. “The war also affects us because the Ukrainians are our neighbors, and we are trying to support them in this difficult time. We have many refugee centers, and any help is welcome.”

“We want to give sincere thanks to all our partners in North Carolina,” says Stempovskaia. “They have big and kind hearts and have done so many beautiful things for our republic, for our people, and for our nurses.”

In June, with help from the Rotary-sponsored nursing collaborative, the State University of Medicine and Pharmacy in Chișinău graduated its first class of students who earned a bachelor’s degree in nursing; the graduates dispersed to hospitals across the country to share their expertise. Meanwhile, members of the nursing collaborative are looking forward to resuming the exchanges between the two countries. At the end of a recent webinar, having concluded her 45-minute lecture, Lekan — who joined the Guilford (Greensboro) club in 2017 — smiles and addresses her virtual audience. “I wish you good health and much success in your work,” she says. “I look forward to a visit to Moldova in the future, and I hope that our paths will cross.” Undoubtedly.

This story originally appeared in the December 2022 issue of Rotary magazine.

An Iraq veteran works through his trauma — and adopts a mission to help others

Clubs seek to increase awareness and understanding of the autism spectrum

By Christine Mungai

When schools in Kenya reopened in January 2021 after a nine-month closure due to COVID-19, Sylvia Mochabo was looking forward to her 11-year-old son, Andy, returning to the classroom. Their schedule, like those of millions of families around the world, had been disrupted by the pandemic, and for Andy, who was diagnosed with autism at age 3 and who struggles with adapting to changes in his routine, the closures and lockdowns were particularly challenging. But his first day back at school didn’t go as planned.

“His school refused to take him back until he was wearing a mask, which Andy isn’t able to do because autism makes him sensitive to physical sensations. Without speech therapy, he began drooling more. He found the mask unbearable,” says Mochabo, a member of the Rotary Club of Muthaiga. Because he wasn’t in school, Andy also lost access to discounts on occupational therapy sessions, which are crucial to his development. Now, Mochabo has to pay the full price for home-based support.

“I’ve had to reduce the number of sessions from thrice weekly to once; without the discount I can’t afford to do all three sessions, even though I know Andy needs them,” she says. “It’s heartbreaking.”

Autism spectrum disorders (ASD) consist of a range of developmental disabilities that can make communication and social interaction difficult and can also cause behavioral challenges. People with autism may think, act, learn, and communicate in ways that are different from most other people. According to the World Health Organization, 1 in 160 children globally has an autism spectrum disorder.

In recent years, the reported prevalence of the disorder has been trending higher, and this is consistent across data sources from countries as diverse as Germany, Iran, and Japan, according to the U.S. Centers for Disease Control and Prevention. It is unclear how much of this increase is due to changes in clinical definitions of ASD or to better efforts to diagnose the condition. However, the CDC doesn’t rule out an absolute increase in the number of people with ASD, and researchers are looking into why this might be the case.

For Rotary member Corina Yatco-Guerrero, her child’s diagnosis came as a shock, even though she and her husband are medical practitioners — she’s a neuro-ophthalmologist and he’s a neurologist. It took them a while to accept their son’s diagnosis and find ways to support him with speech therapy, occupational therapy, and a special needs education.

“For me, the most important thing that parents and families should know is that autism is not a life sentence, that children with autism have a right to life and proper special education that will make them better equipped to face the challenges that they will face,” says Yatco-Guerrero, a member of the Rotary Club of Sta. Ana (Davao), Philippines.

“Parents must learn to accept and not dwell in their state of denial, and to love their children and give them the best in life,” she says. “A child with autism is lovable, and they deserve our love, too.”

Families of children with autism often have to grapple with the lack of social understanding about the condition, even in cosmopolitan cities. Many families experience social stigma, and in some countries the condition is frequently attributed to witchcraft or something that the parents did wrong.

Early interventions, starting before age 5, have been shown to yield the best results for children with autism. “Children need to be assessed at young ages to determine gaps in development and allow for early intervention,” says Pooja Panesar, director and co-founder of the Kaizora Centre for Neurodevelopmental Therapies, a Nairobi institution that uses a step-by-step approach to teach children crucial skills such as communication and toilet training, while reducing behaviors of concern.

“Through this process, we have had great success, from children receiving early intervention who transition into mainstream education to adults who are now living independently and maintaining permanent employment,” Panesar says.

There are several management styles for the condition, and one size does not fit all. Some children might need a lot of help in daily living, while others might be quite independent. “If a child is nonverbal, then having a speech therapist would help. If a child has sensory integration problems, an occupational therapist can help,” says Yatco-Guerrero.

Mochabo, a single mother of three, has found support and encouragement from her Rotary club, and with the help of fellow members, she has started to do more to spread awareness and advocate on behalf of children with special needs. Every year, in partnership with other clubs in Kenya, the Rotary clubs of Machakos, Nairobi, and Thika host the Sunshine Rally, a day of fun, games, and entertainment for children with disabilities.

“I attended a Sunshine Rally and realized that I wasn’t alone in this journey, and being a Rotarian gave me the desire to do more and to be of service to other families like mine,” says Mochabo.

Inspired by the rally, Mochabo founded an organization called Andy Speaks for Special Needs Persons, named for her son, to advocate on behalf of people with special needs and for an end to the stigma they face. “We can support each other all year round,” she says.

Yatco-Guerrero is also involved in creating awareness of autism, in her case through a nationwide organization called Autism Society of the Philippines (ASP). This group advocates for acceptance and integration of people with special needs into society.

“Our Rotary District 3860 has been actively advocating for awareness and acceptance,” Yatco-Guerrero says, “by joining ASP’s annual Angels Walk, a one-day march of persons with autism and their families and teachers. It draws thousands of people by the year, thus earning a spot in the news, which in turn helps disseminate autism awareness throughout the country.”

Other clubs around the world also have organized projects related to autism. The Rotaract Club of Çekirge, Turkey, put together a series of monthly art workshops for autistic artists working with mosaic and painting, and they plan to organize an exhibition of the artworks to raise awareness about autism. In Malaysia, a global grant funded a series of workshops, hosted by more than a dozen clubs, that provided early-intervention training for teachers and primary caregivers of children with autism. The Interact Club of Rio Claro-Cidade Azul, Brazil, with support from its sponsor Rotary club and District 4590, created the Inclusion Symphony, a music therapy room for children with autism, to provide a differentiated therapeutic space and to stimulate and expand the interaction and communication capacity of people with autism. And the Rotary Club of Chicagoland Korean-Northbrook, Illinois, organized a global grant-supported vocational training program for youth on the spectrum.

For Yatco-Guerrero, ultimately the home is ground zero for any kind of autism intervention. “Having a special-needs child means the whole family must get involved to make things work and make life bearable for all,” she says. “It is a labor of love because it is not easy, and it will test your patience to the fullest. But it is your own child who needs your help, and help you will definitely give. It involves a lot of sacrifice, a lot of patience and understanding.” 

Christine Mungai is a writer and journalist based in Nairobi, Kenya. Her work has been published in the Africa Report, Washington Post, Boston Globe, and Al Jazeera English. Mungai is the curator for Baraza Media Lab in Nairobi, a co-creation space for public-interest storytelling.

World Autism Awareness Day is 2 April.

Help support autism-related projects through The Rotary Foundation. Make your gift at rotary.org/donate.

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Ukraine Rotariets magazine editor Mykola Stebljanko, discusses how Rotary clubs in the country are helping and how he is adapting to the increasingly dire situation.

The war in Ukraine has displaced millions of people, creating a devastating humanitarian crisis along the country's borders. In response, The Rotary Foundation set up an official channel for donors worldwide to support relief efforts. At press time, more than $3.5 million has been contributed to the fund.

While the situation is evolving quickly, this interview with Rotariets magazine editor Mykola Stebljanko, conducted in late March, offers a telling picture of the troubling events in Ukraine as well as Rotary's tremendous relief efforts there. Stebljanko discusses how Rotary clubs in the country are helping and how he is adapting to the increasingly dire situation.

What's your situation there now?

I'm living in Odesa. It's the third most populous city in Ukraine, an important port city on the Black Sea coast, in the southwest. Currently, there's no military presence here, but we live under the constant threat of bombs and missiles. Often, air raid sirens will wake us up in the middle of the night. We have to get up and hide in a safe place. In my apartment, the safest place is the bathroom. We huddle together and spend the rest of the night there. Occasionally, we experienced a few rocket attacks, but most of the time, it's a safe place.

As of now, most of the military actions center around Kyiv, the capital of Ukraine, and Kharkiv. More than a dozen smaller cities are also under attack. The city of Mariupol in the southeast of Ukraine is under siege. More than 2,500 civilians have died in Mariupol and close to 400,000 people are trapped, and the Russian army has stopped anyone from escaping. Many are without electricity, water, and heat.

What is happening with Rotary clubs in Ukraine?

There are 62 Rotary clubs in Ukraine. At the moment, only the Rotary Club of Kherson has temporarily suspended meetings, because the city is under the control of the Russian military. I recently spoke with the Rotarians there. None of them are able to escape and they are trapped inside the city. They no longer meet or do any projects for fear of personal safety. Our district governor sent a letter of support to all Rotarians in Kherson.

Other Rotary clubs continue to operate and are trying their best to conduct Rotary services. We have created a special coordination committee. Each club has a representative on the committee, and we meet online twice a day to discuss issues that are facing our clubs.

What kind of relief projects are Ukrainian clubs doing?

Our Rotary services fall into the following three areas:

• The first involves providing help to our hospitals, where a large number of wounded civilians are being treated. The hospitals are in dire need of medical supplies. Our district has set up special accounts and has received about US$100,000 from Rotary clubs and districts around the world. We have already purchased and distributed medicine and equipment. We have also received two Rotary Foundation disaster response grants.
• Second, we are working to coordinate humanitarian aid. Rotary clubs and districts are sending aid via trucks, ships, and air carriers. We are rebuilding Rotary's humanitarian hubs along Ukraine's borders with Poland, Slovakia, Hungary, and Romania. They have received all the supply items and sent them across the border to our cities. Then, we have different hubs inside Ukraine near the border regions, where Rotarians distribute this humanitarian help to the cities that are in dire need of it. Most of the items are clothes, food, and medicine.
• Third, we are trying to help Rotarians' family members who want to leave the country. We have received many requests from Rotarians in Europe and America who would like to host our family members and relatives.

Why don't you leave Ukraine?

I'm already a refugee. I lived in Simferopol, the capital of Crimea, for 40 years. But in 2015, I had to leave my native city because of the Russian annexation of Crimea. So, my wife, Olga, and I moved to Odesa. We felt our move to Ukraine would keep us safe. When people asked us why we do not want to leave Odesa and go outside Ukraine, I always answer: We were forced to leave our motherland once in 2015. We don't want to leave our country again. We are Ukrainians and we would like to stay in Ukraine.

What's your message to the Rotary clubs around the world?

On behalf of Rotarians in Ukraine, I would like to say a big thank you to all our Rotary members who have helped us in Ukraine. It means a lot to us during this difficult time in our country's history. At the same time, I would like to appeal to Rotary people to lobby their governments and push for peace. We are grateful to our friends around the world who are helping us.

• This story originally appeared in the May 2022 issue of Rotary magazine.

Can an all-female anti-poaching unit stop wildlife crime in an African game preserve — without guns?

by Nick Dall                  Photography by Bobby Neptune

Nxumalo and Malungane, who both grew up near the unit's headquarters but only got to know each other since they became Mambas, are checking, as they do every day of their 21-day shift, for breaches in the fence. Mostly this entails collecting rocks to shore up the places where animals such as warthogs and leopards have tried to burrow their way under, but periodically they come across a spot where humans have cut the fence to hunt animals for bushmeat or, worse, poach rhinos for their horns.

In 2013, when the first Mambas began patrolling the reserve, they quickly discovered that rhino poaching was only part of the problem. The park was also losing hundreds of animals of all species to snares every year. "It was embarrassing," recalls Craig Spencer, 48, as he sits by a bushveld braai (barbecue) and talks over the calls of a nearby hyena. A maverick South African conservationist, he was head warden of Balule, a private animal preserve. "I should have known what was happening under my nose. It took the Mambas to show me what was going on."

White rhinos have been hunted almost to extinction in Africa. Of the continent's 18,000 remaining white rhinos, nearly 90 percent are in South Africa, the species' last best hope. Kruger is home to by far the biggest white rhino population, as well as about 300 of the world's 5,600 remaining black rhinos.

The rhinoceros horn is prized in some countries, used as a traditional medicine and a status symbol. According to the Wildlife Justice Commission, a horn fetches an average of $4,000 per pound in Africa, and as much as $8,000 per pound in Asia; given that a set of white rhino horns typically weighs 11 pounds, it's worth between $44,000 and $88,000. South Africa's per capita income is about $5,000 per year and its pre-COVID-19 unemployment rate was about 29 percent. Therefore, a rhino, sadly, is a tempting target. In 2017, poachers killed more than 500 rhinos in Greater Kruger National Park, including 17 in Balule.

"Poachers make me angry," Nxumalo says, because they are killing the animals that all South Africans should be preserving for future generations. While Nxumalo is fully aware that some people poach only out of a desperation to feed their families, her commitment to the cause is unwavering. She points out that it would be devastating for both tourism and conservation to lose a member of what's called the "Big Five," an old hunting term that refers to the five most sought-after animals in Africa: lions, leopards, elephants, buffalo, and rhinos. Rhinos, along with elephants, are keystone megaherbivores that shape the landscape in ways that benefit other species. And the big animals in any ecosystem are usually the canaries in the coal mine, to abuse the phrase. "If we can't prevent keystone species from going extinct," says Tom Tochterman, "other species are also doomed."

Since 2009, when he had an "aha!" moment during his first photo safari in South Africa, Tochterman, 60, has been a passionate supporter of this nature reserve. A retired real estate developer and a member of the Rotary Club of Chelan, Washington, he has since founded a nonprofit called Rhino Mercy, which strives to fight rhino poaching, and developed a luxury photo-safari program that helps to fund conservation work. He also earned a PhD by researching the influence of cognitive dissonance on the consumption of natural resources and ecosystem degradation.

In addition, Tochterman was a founding member of the Rotary Action Group for Endangered Species (RAGES), which has the goal of improving the lives of people by improving the habitats and lives of endangered animals of all types. He welcomes the recent addition of protecting the environment to Rotary International's areas of focus. "We firmly believe that healthy landscapes contribute to healthy communities," he says, adding that "the Mambas have shown that the reverse is also true."

In 2010, Tochterman was at a bush camp, sitting around a campfire with Spencer, the former game warden who is now his close friend and partner, drinking rum-and-cokes and talking long into the night, when they lit a spark that would grow to become the Mambas. "Across Africa, the default response to poaching has been to bring in more men with more guns," Tochterman says. "And it hasn't worked anywhere." It dawned on them that the only way to change the narrative was to shape the minds of the next generation, and that the best way to reach the children was through their mothers.

Tochterman and Spencer eventually learned about a government program to employ women as environmental monitors in conventional agriculture; they thought they could maybe stretch the job description to include "game ranger," but senior management at South African National Parks questioned the concept of unarmed women operating in areas where lions, leopards, rhinos, elephants, and buffalo roam free. Tochterman was told on more than one occasion that this was a "stupid, dumb idea" that "could only have come from America."

When the two men were finally given a chance to put their theory into action, the candidates shortlisted by bureaucrats in the government program were told what the job would entail — and they all quit. So Spencer and Tochterman got permission from the local chiefs to go into communities near the park and look for the right kind of people. The Black Mambas name was chosen by the first group, says Tochterman, symbolizing "how seriously they took their opportunity to enter an industry that had previously been off-limits to women. They wanted to make a statement that they were not window dressing."

Word quickly spread, and within months the Mambas were receiving unsolicited applications from local women almost every day. Since the beginning, the day-to-day operations of the Mambas have been managed by Spencer's nonprofit, Transfrontier Africa. Tochterman was key in building and financing the Mambas' operations hub as well as the separate compound where the women stay during their shifts. He had also spent six years in the military police, so he was able to provide training in skills such as handcuffing a person. Tochterman's Rhino Mercy nonprofit acts as the Mambas' international fundraising arm, and it has brought them financial security. The government recently stopped funding the women's basic salaries (around $450 per month), which was a small fraction of the total cost of the program. Tochterman says that all told, employing one Mamba costs upwards of $50,000 per year.

Nkateko Mzimba, who was part of the Mambas' second cohort in 2014, remembers many men in her hometown teasing her about the job and belittling her chances of survival in what they deemed to be a man's world. Their predictions very nearly came true when, during her first few months with the Mambas, she and two colleagues were repeatedly charged by a pride of lions and had to be rescued from a tree by a passing vehicle. "I tried to quit," she remembers. "But after counseling I decided to stay and prove the doubters wrong." Looking back, Mzimba, now a sergeant who will soon qualify as a professional field guide, realizes that the whole situation could have been avoided if she had better read the lions' behavior.

Mzimba now ensures that every patrol includes a veteran Mamba and that armed response is always on standby. (The Mambas' every move is tracked from a central operations room.) In their first year, it was not uncommon for the Mambas to find 70 snares in a day. They also came across several "bushmeat kitchens," large operations for butchering and drying meat, within the reserve itself.

One full-moon night in 2015, a patrol of Mambas responded to the sound of gunfire and startled a group of poachers who had just killed a rhino. After briefly giving chase in their vehicle, the Mambas returned to the scene to find two rhinos dead and a third one wounded. Despite the best efforts of emergency veterinarians, the third, too, succumbed. The only small mercy of this grisly episode was that the poachers didn't get their prize.

Knowing that the Mambas have played a part in reducing poaching feels "really amazing," says Nxumalo, more so because it's a job that she says she grew up thinking was "supposed to be done by men." To this day, many in the conservation industry in South Africa still feel that women have no place in the anti-poaching arena and that conducting unarmed patrols in Big Five areas is foolhardy. "I don't think men would want to work unarmed in a Big Five area," says Nxumalo with a laugh. "A man would come up with so many reasons why he needs a gun. But for us it's more about reading the animals' behavior. We understand that it's not really about guns."

Through their community connections, the Mambas are also helping to change the cops-and-robbers narrative that has plagued the conservation movement in South Africa since its inception. While nature conservation is often depicted as noble protectors of the environment doing battle with evil poachers and exploiters, this ignores more complex social, political, and economic realities. Shortly after the land that would become the Kruger National Park was set aside and protected in 1898, some 3,000 people belonging to the Tsonga ethnic group were forcibly removed from the land. Fences were erected, national borders that had previously been recognized only on maps were enforced, and people were fined or imprisoned for "trespassing" on the land they had always lived on and hunting the animals they had always eaten. During apartheid, the fences became more impenetrable and the sentences harsher.

This history is vital to understanding how rangers and poachers can come from the same communities — or families. And it's why many of the people who have lived their entire lives on the fringes of one of the world's most iconic national parks know almost nothing about it.

Nxumalo had been to Kruger a few times, but had no real affinity with the bush. After passing a panel interview and a fitness test with flying colors, she and eight other recruits, including Malungane, began their basic training. Training was hard, she says, involving exercises such as "running the whole day in the sun with only a small bottle of water." Now she looks back on that time with appreciation: "Training gave me that go-ahead, that I can be more and do more."

After racking up thousands of kilometers of foot patrols in Big Five areas, Nxumalo loves the bush and remains devoted to the cause. She's not alone — all of the women from her cohort are still Mambas. And they're proud to pass on what they've learned. "We won't only teach our own kids; we will tell other girls that they can do anything," Nxumalo says. "We are telling every lady out there that you can do more, you can be more." While they never go home in their uniforms (a poacher could steal one from a clothesline and use it to infiltrate the park), Nxumalo makes no attempt to hide what she does. "You have to be proud of what you do," she explains. "This inspires others to walk tall. I've always known I could do a lot. But the Mambas really brought it out of me."

The Mambas' salary is considered quite good for the area, so in addition to using her income to support her mother and her sister, Nxumalo has been paying her own university fees. She recently completed the first year of a teaching degree online. Mzimba uses her income to fund and run a food pantry for hungry neighbors — which further aids in reducing poaching.

A typical day for the Mambas involves rising at dawn for a fence patrol or snare sweep (both on foot) and conducting nightly observations from a blind or vehicle. Gunshots, torchlight, and the smell of tobacco smoke are all telltale signs of poacher activity, but these days Nxumalo says the Mambas are more likely to be interrupted by a leopard or a herd of elephants. "They are so peaceful at night," she says. "Sometimes they block the way, but we never rush them."

Weekly tasks for the Mambas include searching the compounds where reserve staff and contractors live, conducting roadblocks, and speaking to tourists and local communities about the importance of wildlife conservation. "If nothing happens on a patrol, that is a big success," Nxumalo says. "If I don't find any snares, that is a bonus because it means that no one has come in to plant a new snare and no one has cut the fence since I last checked it. It's a huge relief."

Our progress in the fight against polio shows why vaccination is important

Increasing awareness about the power of vaccines and closing immunization gaps could protect millions of people worldwide from vaccine-preventable diseases, including polio, according to the World Health Organization. World Immunization Week, 24-30 April, is an opportunity to focus on that work, and the robust polio eradication infrastructure built by Rotary and our partners in the Global Polio Eradication Initiative (GPEI) provides a model for it.

The GPEI estimates that polio vaccines have saved an estimated 20 million children around the world from paralysis. When Rotary helped launch the GPEI in 1988, the disease paralyzed more than 1,000 people worldwide every day, most of them young children. Since then, Rotary and its partners have reduced the number of polio cases by 99%, and in 2021 there were just six cases of polio caused by the wild poliovirus. Afghanistan and Pakistan are the only two countries where the wild poliovirus remains endemic.

The progress against polio is the result of the efforts of countless volunteers and health workers who immunize children in hard-to-reach communities and establish real-time global surveillance and outbreak response mechanisms. The polio eradication infrastructure has been used to fight other infectious diseases and undertake crucial health interventions, including supporting COVID-19 prevention and vaccination efforts.

With our decades of experience in bringing polio to the brink of eradication, Rotary has been able to highlight the power and efficacy of COVID-19 vaccines. Since the pandemic began in 2020, Rotary members have helped health authorities communicate lifesaving information about COVID-19, dispel misinformation, and support fair and equal access to vaccines.

Download Rotary's World Immunization Week toolkit for graphics and information.

Every Vaccine Counts Video

SPH Week At a Glance

Why it’s important to consider gender at all levels of eradication work

by Heather Monnet, External Relations Officer and Gender Focal Point for Polio Eradication, World Health Organization

How do issues surrounding gender create barriers to polio eradication? 

Our ultimate objective is to reach every last child with a polio vaccine. The role of the mother and father in reaching those children is very important, and we must understand the dynamics between them in order to achieve our goal. For example, a mother may want to have her child vaccinated, but that would require her to spend a day walking to a health center or market — and she might not be able to do that unless she gets permission from her husband. Or if her child falls ill and experiences paralysis in the arm or leg, the mother might have to seek permission from her husband to take the child to the health center. There could be a delay of several days that would affect our ability to take stool samples and determine whether that child has polio or not.

Do more boys than girls receive vaccines?

On a global level, there is very little discrepancy between reaching boys and girls. You also see a more or less equal distribution of cases of polio between boys and girls. But the global statistics can mask disparities at the local level. We know that we have communities that are not being reached; we need to understand why we’re not reaching them. Gender plays a huge role in both supply of and demand for immunization. Who is providing the immunization — a man or a woman? Who is the decision-maker — mom or dad? And how do the immunizer and the decision-maker work together?

What are the key points in the gender strategy you helped develop for the Global Polio Eradication Initiative (GPEI)?

The polio program has typically engaged women as frontline health workers because in some cultures, mothers are more likely to open the door to a female vaccinator. But women should not just be part of the delivery of the program. They should also be part of its design; they should be supervisors and team leads, and hold positions at the district level to make sure we are meeting the needs of communities. We also need to understand why we have trouble retaining female vaccinators. We want them to keep working with us.

We must look at our data in a way that allows us to understand the program better and to see where there may be gaps. Collecting and analyzing sex-disaggregated data will help us to understand if gender-related barriers are preventing us from reaching zero-dose children — children who have not received any vaccines — and to refine the way we plan campaigns in those countries.

The GPEI’s new strategy places a huge focus on community engagement. We’re looking at the supply and demand sides in communities. How do we create a demand that ensures that parents want to take their children to be immunized? We need to make sure that the offered immunization services are acceptable to parents.

Besides gender, are there strategies that focus on other types of diversity?

We’re also looking at engaging people with disabilities. And gender also covers economic status: A lot of gender disparities are much more pronounced at different economic levels as well as in different ethnic and age groups. For example, the decision-making power of women in developing countries who are not educated is more limited, which will impact their ability to make health care decisions for the family. All of those things interact.

In the last mile of eradication, we need to leave no stone unturned to understand which children we are missing and why. Looking at gender is one more way to make sure that we’re reaching all children. Fathers have just as much of a role to play as mothers. How do we overcome barriers, so that men are engaged in the decision-making process and so that they allow their children to be immunized?

Rotary is so well-positioned to be a lead on gender. It isn’t a women’s issue — it’s everybody’s issue.

This story originally appeared in the December 2021 issue of Rotary magazine.

by Diana Schoberg

In December 2017, on his first night as a Peace Corps volunteer in the ancient North Macedonian city of Štip, Cal Mann was welcomed with a raucous party at a rustic cabin far outside of town. There was an abundance of food and drinks, and a boom box blared local music. As the party raged well past midnight, Mann watched, beer in hand. “I’m like, I can’t do this for two years, that’s for sure,” he recalls.

So you can understand his trepidation the next day when he found out a barbecue was in the works. Being a good sport and new to the city, he opted to go — a pivotal decision, it turns out. At the barbecue he struck up a conversation with a man named Zoran Kolev, who spoke English. As talk came around to Mann’s work as a Peace Corps volunteer, Kolev mentioned that there was a new service club in the city: the Rotary Club of Štip.

“He told me they had just started the club a few months before,” Mann says. “They didn’t really know what Rotary was, but someone had told them it was a good thing to do.” This was great news to Mann, who had been a Rotary member since 2004 (and who currently belongs to the Rotary E-Club of Silicon Valley).

“I was thrilled to have met someone involved in Rotary so I could tap into my experience there. And they were happy to have someone who knew what Rotary was.”

Mann’s primary assignment with the Peace Corps was to work with a legal clinic for Roma residents, but volunteers are encouraged to take on a side project. Rotary became his. “I had just linked up with a club of people with big networks in the community, and most spoke English,” Mann says. “I may be dumb, but I’m not stupid. I figured that’s a pretty good opportunity. I better jump on it.”

Mann connected the club with a youth group and worked on small projects such as litter cleanups. When two Peace Corps volunteers in Štip who were teaching English needed more books, Mann talked to the club about finding a local distributor and also reached out to his friends at the Rotary Club of La Jolla, California, where he’d been a member previously, to connect them with the Štip club so that they could work together on the project.

Mann’s supervisor at the Peace Corps took notice. By the end of 2019, Peace Corps Northern Macedonia had placed four Peace Corps volunteers with Rotary clubs in the country. “The clubs loved it because they got volunteers who were really knowledgeable in the area of community development and who had a lot of ideas, energy, time, and skills,” Mann says. “The volunteers loved it because Rotary clubs immediately gave them a good connection to their community and a natural circle of friends.”

It was a match made in heaven. Rotary and the Peace Corps seemed meant for one another — as subsequent developments would demonstrate.

It was an impromptu speech by John F. Kennedy, just weeks before the 1960 presidential election, that catapulted the idea of a volunteer corps of Americans into public consciousness. Speaking from the steps of the student union at the University of Michigan, he challenged students, who had been waiting until well after midnight for his arrival, to contribute part of their life to service. The idea took hold, and hundreds of students signed petitions pledging to volunteer. In March 1961, President Kennedy signed an executive order creating the Peace Corps. “‘Ask not what your country can do for you — ask what you can do for your country’ was very real for me,” says Ted Bendelow, a member of the Rotary Club of Mead, Colorado, who joined the Peace Corps six months after Kennedy’s assassination and served in Liberia from 1964 to 1966.

In the 60 years since its creation, more than 240,000 Americans have served in the Peace Corps. Chances are there might be a returned Peace Corps volunteer (known as an RPCV) in your club or district. “They pop up in Rotary more than you might think,” says Charlie Hunt, a member of the Rotary Club of Denver Lodo, who served in Vanuatu from 2006 to 2008. Hunt recalls attending a Rotary club meeting while traveling to another part of the United States and hearing an opinionated academic speaking about Iran. “A Rotarian took her to task,” Hunt says. “He said he had spent two years in Iran. He had been a Peace Corps volunteer.”

The relationship between Rotary International and the Peace Corps, made official with a 2014 partnership agreement, has its foundation in the organizations’ shared values. The mission of the Peace Corps — “to promote world peace and friendship” — is one Rotary has embraced for more than 100 years. And the Peace Corps’ chief areas of focus — agriculture, community economic development, education, environment, health, and youth in development — have much in common with Rotary’s.

The Peace Corps has three goals: providing training for men and women in interested host countries; helping people in those countries to better understand Americans; and helping Americans to better understand other peoples. Service, therefore, is meant to continue once volunteers return home. “The third goal is not necessarily just about telling stories about your Peace Corps experience,” Hunt says. “It’s about being active in your community and how you can best take the things you’ve done in the Peace Corps and apply them when you come back.”

Steve Werner, a member of the Rotary Club of Denver Southeast and a Peace Corps volunteer in Korea from 1976 to 1978, recalls a meeting in the early 1990s with JFK’s brother-in-law Sargent Shriver, who had served as the first director of the Peace Corps. Then the board chair for the National Peace Corps Association, Werner stopped by Shriver’s office to have him sign some fundraising letters, a task he thought would take only 15 minutes. But Shriver was in the mood to talk. “He told me that the vision was that once a Peace Corps volunteer, we would always be a Peace Corps volunteer,” Werner says. “We would continue to serve after we got home to be examples to our fellow Americans. It was a big part of my motivation for becoming a Rotarian.”

Werner served another tour as a Peace Corps volunteer in the country of Georgia in 2016, this time with Peace Corps Response. While similar in approach to the two-year traditional program, Peace Corps Response assignments are shorter (generally 9-12 months) and involve higher impact projects geared to volunteers with more technical expertise in a particular program area.

Elsewhere in 2016, Andy Lenec was listening to NPR with his son when he heard an interview with the oldest active Peace Corps volunteer at the time: 87-year-old Alice Carter, who had just finished her first year in Morocco. “I’d been a Rotarian for over 25 years and service is second nature to me,” Lenec says. “I looked at my son, and he said, ‘Go for it, Dad.’ The next thing I know, I’m filling out the Peace Corps application form online.”

Lenec was assigned to Truskavets, a small city in western Ukraine near the Polish border where a Rotary club had applied for a Peace Corps volunteer in partnership with the city government and library. The club was small but committed. “Because of economic struggles, Rotary in Ukraine can cost as much as one month’s salary for annual dues,” Lenec says. “Many just cannot afford it. So a club of what used to be 20 was down to maybe 4.”

Once in Truskavets, Lenec decided that he wanted his side project for the Peace Corps to involve young people. He proposed an international youth conference to the Rotarians, and they jumped at the idea, as did the city’s mayor. As Lenec traveled to other Rotary clubs to encourage them to support the conference, a Rotarian asked if the conference could be turned into a Rotary Youth Leadership Awards event, which was defunct in the country. Lenec had been involved in RYLA for years and had seen the impact it makes on youth. Now he had a new goal: “We were going to revive RYLA in Ukraine,” he says.

Unfortunately, Lenec became ill while planning the event and had to return to Colorado, where he is now a member of the Rotary Club of Denver Lodo. But another Peace Corps volunteer in Ukraine, Shannon Carter, stepped in and worked with Rotarians to keep the momentum going. During the summer of 2019, the RYLA took place; 17 young people from Ukraine, Japan, and Armenia participated. “It cemented faith in the program,” Carter says. Carter then helped organize a virtual RYLA in 2020 with more than 700 registered participants.

Unlike Lenec with his decades of Rotary experience, Carter had none. But she soon discovered how valuable the Rotary network would be, both with RYLA and her future projects. Following up on work Lenec had done to raise awareness of the RYLA project with clubs in North America, Carter was introduced to Gordon Crann, a member of the Rotary Club of Hamilton After Five, Ontario. Crann, who has an extensive global network as past chair of both the Rotary Action Group for Peace and the Rotary Action Group for Community and Economic Development, offered to help Carter promote RYLA. Then he went one step further: He suggested she also apply for a Rotary Peace Fellowship.

“I was very impressed by Shannon and her organizational ability,” Crann says. “She was the key person in bringing everything together, and this was an interna-tional effort. Peace Corps volunteers have shown they have a commitment to Service Above Self by taking time off [for public service], when they could be making a lot more money in jobs in the United States.”

Carter applied, and today she is a Rotary Peace Fellow at the University of Bradford, England, and a member of the Rotaract Club of Lviv International, Ukraine. “I went into RYLA anticipating personal growth, but I didn’t foresee the international network I would gain that would provide future opportunities like the Rotary Peace Fellowship,” Carter says. “My experience as a Peace Corps volunteer cemented my confidence in myself and made me realize we are fully able to do what we want in life.”

One of the driving forces behind the Rotary-Peace Corps partnership at the international level is a group of returned Peace Corps volunteers from Colorado who named themselves the “Tiger Team,” after a dog owned by one of its members. The group began meeting in November 2009 at the instigation of Sue Fox, a past president of the Rotary Club of Denver and a returned Peace Corps volunteer who served in Liberia from 1968 to 1970. Fox recognized the potential for the two groups; as she told a local business magazine at the time, “RPCVs and Rotarians are kindred spirits, seeking the same goals embodied in Rotary’s motto, Service Above Self.”

Students register for the regional English-language spelling bee in Štip. Nationwide, more than 3,000 students participate in this highly competitive contest, which is facilitated by volunteers from the Peace Corps and Rotary.

The Tiger Team expanded to include other Rotarians as well as returned Peace Corps volunteers who were not affiliated with Rotary. Their group, which became the organization Partnering for Peace, proposed to Rotary International and the Peace Corps administration that a formal alliance be established between the two organizations. That step was taken in May 2014, and the partnership was recently renewed for another three years.

by Aidan O’Leary                Illustration by Viktor Miller Gausa

“There’s something about the whole idea of eradicating polio that grabs the imagination,” says Aidan O’Leary. “Most people talk about making steps toward achievements, and it’s almost always into the never-never. Eradication is a zero-sum game; anything short of zero is failure. You keep getting closer and closer, but ultimately the only number that actually matters is zero.”

Although O’Leary, the polio eradication director for the World Health Organization, is speaking from his home in Galway, against the verdant backdrop of western Ireland, his focus is on war-torn Afghanistan and the parched and dusty plains of Pakistan — the last two places on the planet where wild polio still thrives.

Even during a pandemic, even as grim realities confront him, O’Leary conveys a sense of optimism about the possibility of finally eradicating polio. “Particularly in the days of COVID-19, there is something that really resonates about snuffing out a highly communicable infectious disease,” he says. “As COVID has taken off, it has also led a lot of people to better understand why now is the time to finish this job with polio.”

Yet O’Leary’s optimism is shaded with a sense of urgency and pragmatism. “There is absolutely no case for complacency here,” he says. “What is really important is that we double down on reaching the persistently missed children who are a top priority for our program.”

O’Leary, who began his tenure as WHO’s polio chief in January, came into the job knowing the terrain well. He formerly led UNICEF’s polio eradication efforts in Pakistan and was the head of the United Nations Office for the Coordination of Humanitarian Affairs in Afghanistan, Iraq, Syria, and Yemen, organizing the UN’s emergency response during crises.

O’Leary says he understands the difference Rotary can make — both in a community and in the global fight against polio. In Galway, a local tradition involves kicking the limestone wall at the end of a 2-mile stroll on the Salthill Promenade along Galway Bay (the reason for doing so has been lost in the mists of time). In 2012, O’Leary explains, the Rotary Club of Galway-Salthill installed on that wall a box that bears the slogan “Small Change, Big Impact” and encourages walkers to leave a small donation, with all money collected going to local charities and institutions.

In July, weeks before the dramatic turn of events in Afghanistan, O’Leary joined Rotary magazine senior staff writer Diana Schoberg and Dave King, editor of Rotary magazine for Rotary International in Great Britain and Ireland, on a Zoom call to discuss the new strategy of the Global Polio Eradication Initiative (GPEI) and the new polio vaccine, and how they will be used to eradicate polio — once and for all.

What is the latest update on wild poliovirus?

The numbers are extremely encouraging. We’ve gone over a very bumpy road during the last two years. We had a fivefold increase in cases between 2018 and 2019, when we saw 176 cases, and we had 140 cases in 2020. But we’ve recorded just two cases this year [as of 27 July] — one each in Afghanistan and Pakistan. [Both cases were in January.]

The particularly encouraging part right now is that the program has a very elaborate network of environmental testing sites for sewage — almost 100 sites in Afghanistan and Pakistan that cover all of the major population centers. In 2020, almost 60 percent of the monthly test samples came back positive for poliovirus. This year to date, that percentage is probably around 15 per-cent. We have been unable to detect any wild poliovirus in Afghanistan since 23 February, and we’ve seen just five isolates in Pakistan since 12 April.

Why do you think that is? Given that some polio immunization campaigns had to be suspended last year, you’d think the numbers would have gone in the other direction. Is it because so many elements of society were shut down due to the pandemic?

While conditions in 2020 were certainly adverse both for surveillance and for the campaign operations, there are two areas that are helping us this year. One is reduced mobility — both within Afghanistan and Pakistan, and across the borders. When you look particularly at the experience in India, with the explosion of COVID cases in the first and second quarters of 2021 — and what were some very shocking images of funeral pyres — I believe that the drop in mobility has had an impact. There has also been a change in social norms, very simple things like social distancing and hand washing. Maybe that has made some impact, as well. But those are short-term changes.

With the conflict in Afghanistan, we don’t believe that the benefits we’re seeing from reduced mobility will continue indefinitely. We need to continue to prepare for the possibility of large-scale displacements across borders. We need to grab the opportunity that we have.

Now we’re coming into the high season for polio transmission, so we’ll continue to wait and see. There’s certainly no complacency from our program.

"The single most important relationship that the program has is between a frontline vaccinator and the caregiver who answers the knock at the door."

Vaccines are on everyone’s mind because of COVID. Has that affected acceptance of the polio vaccine?

For me, the more fundamental issues in Afghanistan and Pakistan center around household and community confidence and trust. If you get the basics of that right, you are 80 to 90 percent there. The challenge has always been reaching the other 10 to 20 percent.

The key issue is broader — the marginalization of communities. That’s not something that can be addressed just at the household and community level. It requires a systemic engagement to try to make sure that we properly understand the community’s actual needs and then that we connect those dots in a more reliable way.

The single most important relationship that the program has is between a frontline vaccinator and the caregiver who answers the knock at the door. That caregiver is usually the mother, and what’s really important for our success is that the frontline vaccinator is a local woman who is well-trained and motivated to do what she’s doing. If that relationship of confidence and trust is developed, then you’re able to vaccinate all of the children inside the house.

Because of the suspension of house-to-house vaccination campaigns in 2018 in areas of Afghanistan controlled by the Taliban, more than 3 million children routinely miss vaccinations. Do you think that polio eradication is possible while the security situation in Afghanistan is so unpredictable?

We continue to speak with all parties. Our priority is the protection of children, and that requires engaging with all stakeholders. We have an agreement with the Taliban to conduct mosque-to-mosque campaigns, which we hope we’ll be able to initiate in the coming months. In some cases, we’ll be reaching children for the first time in several years. We’d like to build on those opportunities toward resuming house-to-house vaccination campaigns.

We don’t have an all-or-nothing situation. Let’s seize the opportunity to reach 40 to 50 percent coverage before we start talking about 100 percent. Will the campaigns in July and August be perfect? No. They’re taking place against the backdrop of a growing full-scale conflict, so we have to make sure that we find appropriate ways of making that work.

There will be risks. Eight frontline workers were killed in eastern Afghanistan earlier this year in various targeted killings. In these contested areas, the de facto authorities on the ground shift. We need to make sure that we navigate these areas as sensitively as we possibly can.

We are also working on financing essential immunization coverage [universal access to all relevant vaccines], particularly in the provinces of the southern region of Afghanistan. We recognize that it’s not just a polio gap. There’s a much broader gap.

The other point that I would highlight is the importance of the surveillance system. Although we have not been able to reach all children with vaccinations, our surveillance system is continuing to pick up all the acute flaccid paralysis cases. There is a basic system in place that allows us to properly understand what’s going on. We want to build incrementally and in a sustainable way to make sure that we have access in all of these areas for the purposes of our immunization programs.

What about in Pakistan, where 81 percent of the cases are among the Pashto-speaking population, who make up 15 percent of the overall population. Why are the cases so concentrated within that group, and what is the program planning to do to address it?

It’s often presented as a vaccine acceptance issue, but I think it’s much broader than that. Because of economic migration, among other reasons, you have this massive influx of Pashto-speaking people from across Afghanistan and Pakistan into Karachi. You’re seeing this huge explosion of settlements — formal, informal, and everything in between. These settlements tend to be highly underserved. There can be issues between the state and provincial administrations and these minority communities. There’s a wider issue around community acceptance, confidence, and trust.

The polio eradication program is one of the few programs that reaches these communities, but their needs go way beyond polio vaccines, including clean water and sanitation, nutrition, basic health services, and education. So when you are trying to access these informal settlements, you have this big residue of issues that polio essentially becomes the proxy for.

These issues are not strictly within the control of our program, but we recognize that to build the acceptance and trust of these communities, we’re going to have to make a much more sustained effort than we perhaps may have been doing in the past. The idea on our side is to move from patchy and ad hoc initiatives to something much more comprehensive and systemic.

Zero-dose refers to any child who has never had a vaccine. We want to make sure that they not only get the oral polio vaccines but also as many other essential immunizations as is feasible. It’s not just a question of a fixed, static target of high-risk children in core reservoirs — those areas with persistent wild poliovirus transmission. There is a rolling target that we have to stay on top of. We’re in a race against time with newborns. There are between 7 and 8 million babies born every year in Pakistan. So we need to make sure that within the first months of those babies’ lives, we’re reaching as large a proportion of them as we possibly can.

What’s your best guesstimate of your target?

Every time we do a national immunization campaign in Pakistan, which are house-to-house campaigns, we target more than 40 million children under age 5. When we go to Afghanistan, that number is between 9 million and 10 million. It continues to be very humbling to see what frontline workers are doing during a pandemic.

We’re dealing with two issues here, aren’t we — wild poliovirus and the circulating vaccine-derived poliovirus. What is the difference between the two?

The wild poliovirus is essentially as its name describes. It’s the original of the species. It has evolved over centuries and millennia, and it has continued to evolve.

The oral polio vaccine contains a live but weakened virus, which can circulate among under-immunized or unimmunized populations for a long period of time, usually for years. And eventually, it can revert to a form that causes paralysis. That is circulating vaccine-derived poliovirus [cVDPV].

Viruses require an immunity gap. They need susceptible children. Anywhere there are zero-dose children, you’re going to find these diseases taking off. When we map where these children are, we keep coming back to the same locations again and again. That’s why we really have to double down and make sure that these zero-dose children are our very top priority to get covered by vaccination.

Globally, how widespread is cVDPV?

There have been 1,800 cases since 2016. Between 2018 and 2019, there was a tripling of cases, and then there was a further tripling between 2019 and 2020. The total number of cVDPV cases in 2020 was 1,103. So far in 2021 [as of 27 July], there have been 179 cases. We’ve seen real progress as immunization campaigns have resumed. The number of countries with cases has decreased from 27 last year to just over a dozen.

These cases happen where children miss vaccinations. When children are fully vaccinated, cVDPV is not a problem. These cases are highly concentrated, with Afghanistan and Pakistan making up 40 percent of cases in 2020. If you look at the situation in Afghanistan, which was the country with the greatest number of cVDPV cases last year, more than 90 percent of those were concentrated in the areas that were inaccessible due to the Taliban banning house-to-house polio campaigns.

So again, the challenge for us is to protect through vaccination. You create a risk by not building up the immunity levels as high as they could or should be. As a program, we are trying to get back to a stage where we’re going after the root cause of the problem — which means making sure that we are fully vaccinating all of these zero-dose children.

Here’s how joining a Rotary club helped enhance Ashley Holmer’s work

Ashley Holmer is a member of the Rotary Club of Lewis River (Battle Ground), Washington

Looking for a meaningful year-abroad experience, Ashley Holmer decided to teach in Tanzania. The former college soccer star coached and taught English in a Maasai community in 2005.

But Holmer soon became more deeply involved in education in Tanzania. She co-founded the Indigenous Education Foundation of Tanzania (IEFT), which established a school in the village of Orkeeswa in 2008. In 2011, the leaders of Mungere village asked Holmer to help build its first community high school. That was the beginning of the Red Sweater Project, named for the color of the school uniforms. Since then, the Mungere School — and education — has been a central part of Holmer’s life.

The Red Sweater Project focuses on three main areas: quality education, gender equality, and responsible innovation. In Tanzania, many children — especially girls — leave school around age 12, in part because of costs for uniforms, school supplies, meals, and transportation. To keep students in the classroom, the project makes education affordable by reducing those ancillary costs.

In 2013, Holmer, who still spends about half her time in Tanzania, was invited to a meeting of the Lewis River Rotary club. She was struck by the way her values meshed with those of Rotary but was unable to join at the time because of attendance requirements. In January 2017, with those requirements having become more flexible, she became a member.

The club has embraced Holmer’s work and sponsors scholarships for six students each year to attend the Mungere School. “We have students whose parents are illiterate,” Holmer says. “One of my students just finished her teacher training. It’s coming full circle.”

— NIKKI KALLIO

• This story originally appeared in the March 2021 issue of Rotary magazine.

FOR IMMEDIATE RELEASE

Media contacts: Clinton Bennett, DHSS, 907-269-4996, clinton.bennett@alaska.gov
Public inquiries: State COVID-19 Vaccine Helpline, 907-646-3322

Administration of Johnson & Johnson COVID-19 vaccine paused for national safety review; mRNA vaccine administration will continue in Alaska and nationally

April 13, 2021 ANCHORAGE – Out of an abundance of caution, vaccine providers in Alaska have been asked to pause all use of the Johnson & Johnson (J&J) COVID-19 vaccine (Janssen) immediately, in accordance with a joint announcement from the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration this morning.

All upcoming appointments with the J&J vaccine are being canceled in Alaska. This is because CDC’s Advisory Committee on Immunization Practices (ACIP) is reviewing six cases of a rare and severe type of blood clot in women aged 18-48 years after vaccination with the J&J vaccine. Symptoms in these patients began 6-13 days following vaccination.

ACIP will meet tomorrow, April 14, to review the relevant data. Meanwhile, administration of Pfizer and Moderna vaccines will continue both in Alaska and nationally. The Pfizer and Moderna mRNA vaccines are considered extremely safe and effective.

Anyone who was scheduled to receive the J&J vaccine in Alaska this week should be aware that their appointment will be canceled or postponed. If you need help rescheduling your appointment to instead receive one of the mRNA vaccines (Pfizer or Moderna), please call the Alaska Vaccine Helpline at 1-907-646-3322 or toll-free 1-833-4-VAXLINE (1-833-482-9546).

“We take every vaccine adverse event seriously. This pause is an important part of the process that ensures the safety of the COVID-19 vaccines,” said Dr. Joe McLaughlin, Alaska’s state epidemiologist. “This is how our safety checks work. DHSS is notifying vaccine providers via email and phone calls this morning and is also providing information to all health care providers. Alaskans should also know this appears to be a very rare event, with six cases out of 6.8 million doses of J&J vaccine administered to date.”

As of April 12, there have been 11,178 Johnson & Johnson vaccine doses administered in Alaska out of 35,500 doses allocated in the state. This vaccine has been delivered to a number of sites in Alaska, including pharmacies, outpatient clinics, federally qualified health centers and local public health authorities.

The six U.S. cases were flagged in the Vaccine Adverse Events Reporting System (VAERS), a component of national post-licensure vaccine safety monitoring. None of these six cases occurred in Alaska. Anyone who has received the vaccine who develops severe headache, abdominal pain, leg pain, or shortness of breath within three weeks after vaccination should contact their health care provider or seek medical care.

Health care providers are asked to report adverse events to VAERS.

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The Israel-based charity ‘Save A Child’s Heart’ reaches across conventional political boundaries for the welfare of children. Watford Rotarian, David Silverston, a trustee of Save A Child’s Heart UK, describes the amazing work which is taking place.

They will also be recognized at the 2021 Virtual Convention for their outstanding contribution to health.

Rohantha Athukorala

Rotary Club of Colombo Reconnections, Sri Lanka

In April while Sri Lanka was on lockdown due to the COVID-19 pandemic, Rohantha used his time in isolation to rally other members across Sri Lanka and create Stop the Spread, a comprehensive effort to reduce new infections through behavior changes. The program brought the country's top athletes together with some 15,000 Rotarians, Rotactors, and Interactors to create awareness of health protocols and behavior change that can slow the spread of the disease. They also created a certification program for businesses that met new health and safety protocols addressing the spread of the virus. More than 300 businesses have been certified including schools, supermarkets, hotels, and tea and apparel industries. Read more about the project.

Julie Dockrill

Rotary Club of Timaru, New Zealand

In 2013, Dockrill and other midwives introduced a Maternal and Infant Health Education program in Mongolia that has been adopted by the Ministry of Health. They created a "train the trainer" curriculum and made numerous trips to the country to help educate healthcare workers, university students, and expectant mothers about safety practices and protocols of childbirth. Since the program was launched in Mongolia, the mortality rate among pregnant mother and newborns has decreased by 60%.

James Ham

Rotary Club of Honolulu Sunset, Hawaii, USA

The Homeless Outreach & Medical Education (H.O.M.E.) Project has provided free medical services through weekly clinics in nine sites across Oahu, Hawaii. Ham, an emergency physician in Honolulu and an assistant clinical professor at the University of Hawaii's school of medicine, began volunteering with the project four years ago. Ham's Rotary club purchased and stocks a mobile clinic that expands the project's reach. To address the COVID-19 pandemic, Ham organized 12 Rotary clubs to provide hot meals and masks and hygiene kits to a quarantine camp for homeless people, as well as PPE to the volunteers who offer frontline care.

Mohan Kumar

Rotary Club of Bangalore Prime, India

Since 2007, Kumar's Reach the Unreached organization, has led efforts to provide prosthetic hands to more than 20,000 people in mostly economically-challenged communities of Africa and South Asia. He credits volunteers with leading him to the people who most needed help: among them, a mother who can now hold her baby, a barber able to resume his profession, and a boy who lost both hands in an electrocution accident. According to Kumar, accidents often lead to amputation among the more than two-thirds of India's 1.3 billion inhabitants who live in low-income rural areas.

Isabel Scarinci

Rotary Club of Birmingham, Alabama, USA

Scarinci, a polio survivor, has been a strong advocate for polio eradication. She is now leading efforts to eliminate another disease: cervical cancer. Funded by a Rotary Foundation global grant, the Rotary clubs of Birmingham and Colombo (Sri Lanka) have joined with the Sri Lankan Ministry of Health and the O'Neal Comprehensive Cancer Center at the University of Alabama-Birmingham, where Scarinci is a behavioral scientist, to vaccinate girls in Sri Lanka against the human papillomavirus and to screen women for the disease at ages 35 and 45.

Scarinci contracted polio as an infant in Brazil in 1963. She recovered, and together with her mother, has become a strong advocate for polio vaccination.

Teguest Yilma

Rotary Club of Addis Ababa Entoto, Ethiopia

On World Polio Day last October, Yilma, chair of Ethiopia's PolioPlus committee, collaborated with the Ministry of Health and the World Health Organization to conduct a high-level panel discussion that addressed the problems COVID-19 created for ongoing polio eradication efforts. The media attention that event received helped people understand the importance of continuing National Immunization Days and spurred the government to continue providing polio and measles immunizations throughout the pandemic.