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A view on the ground
A Gates Foundation Trip

Simple Advances, Amazing Benefits in Africa

In December 2009, I went to Africa on a Gates Foundation trip. It’s really helpful to get a view on the ground of work we’re doing, and to meet the people who are making it happen.

For all the benefits that modern healthcare technology has to offer, it was amazing to see how simple advances in basic sanitation and personal hygiene are making such a difference for the poor in South Africa. And in Kenya, I saw first-hand how the innovative use of cellphones and modest investments in food handling are improving people’s lives.

My trip started in Durban, South Africa, where I met with Neal Macleod, head of Durban Water and Sanitation. Neal has been a leader in thinking through how to improve sanitation for the poor in Durban. Most of us take for granted the convenience and sanitation benefits of flush toilets. But in Durban, many people don’t have access to water. So reducing the incidence of diarrheal diseases and worm infections associated with the use of pit toilets is important – especially for young children who are the most vulnerable. Neal showed me the VIP toilet – which isn’t as fancy as its name suggests, but is a breakthrough in basic sanitation through the use of simple ventilation methods and other inexpensive construction methods, such as installing a fly screen on the ventilation pipe.

After that, I travelled 590 kilometers northwest of Durban to Bophelo Pele, a male circumcision center near Johannesburg that has had incredible success demonstrating how this simple procedure can reduce – by more than 60 percent – the transmission of AIDS from women to men. I met with Professor Bertran Auvert, a French scientist, whose research also proves to skeptics that teenage and adult men are willing to be circumcised. Since the project began, more than 14,000 men have been circumcised, in a procedure that takes a doctor just 7 minutes and costs less than $40. It’s a remarkable example of how modest and wise investments can save lives and significantly reduce the financial impact of AIDS, especially in countries where the infection rate is so high.

In Kenya, I visited Eldoret, where we saw how M-PESA, an innovative cell phone service offered by Safaricom, the local telecommunications provider, is making basic financial services available to poor people. This is a big goal of the foundation, so I was excited to see how popular M-PESA has become. Everywhere I went, I saw the M-PESA logo (“pesa” is Swahili for “money”). M-PESA is an affordable, fast and safe way for people to deposit, save and transfer money anywhere in Kenya. Safaricom is now getting banks and insurance companies involved and the service is spreading to other countries.

In the nearby town of Kabiyet, I saw how an even simpler and older technology – a chilling plant – is helping improve the lives of local dairy farmers. In the past, farmers had to sell their milk within two to three hours or it would go sour. With the new chilling plant at Kabiyet Dairies Company, Ltd. (which the foundation’s grantee, Heifer International, helped finance), the milk can be properly chilled and checked for quality. Now, farmers are getting almost double the price. I met one farmer who told me that he is now able to send his kids to school because of the extra income he earns. In addition, the Kabiyet facility has become a center for a lot of other services that local farmers need, including artificial insemination of cows, veterinary services, and supplements that help dairy cows produce more milk.

Africa is home to 15 percent of the world’s population and many of its poorest citizens. While the continent faces many challenges in reaching the targets of the Millennium Development Goals, the projects I visited show how progress in reaching these goals is possible and can be accelerated. That’s why Africa is a particular focus for the foundation.

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