“Where do the $ go?”

By Dr Darren Weiss, Executive Director, HSF

The potential sponsor did not like the answer I gave.

“All our funds go to salaries for our workers plus related HR costs such as transporting and insuring our staff.”

Not the answer he was hoping for. The donor wants almost all funds going to the community and only a very small proportion going to admin. I truly understood and empathized with his view – we all want our donations to impact the underserved people in need – not the bank accounts of the staff or the landlord who collects the office rent.

That’s how the meeting began. A long discussion about the details and some insights of HSF ‘s work ensued, after which the potential sponsor concluded the meeting with: thank you for opening my eyes to a different way of looking at CSR (Corporate Social Responsibility).

You can browse this website for info and pics about the work we do in our communities, so I’ll skip that part. Following is the explanation of why our funds don’t flow directly to the communities. But firstly I’ll point out that our local team members are themselves from the marginalized communities we serve. So the local team expenses, at least, do flow to the communities. That’s roughly half our staff, and includes Project Managers, Community Health Workers, Health Promoting Ambassadors etc. The other (global) half of our team are professionals earning the retainers that need to be justified.

Impact Driven Workflow

All our projects are different – because each community is different. Each project will have its unique alliance of partners that will always consist of non-profit, governmental, academic, and corporate partners.

At times, we have been involved with food parcel distribution – we will occasionally bring a food-parcel distribution organization into a collaboration.Food parcel distribution is the type of initiative that the potential sponsor would presumably be most happy to support – almost all the funds go towards the food parcels, all of which are distributed within the community by volunteers. Nevertheless, Humble Smile won’t fund food parcels: A. because there are already orgs doing that, and our network is developed enough to be able to engage and leverage those partners, and; B. while handing out food does help and impact the under-resourced recipient families, it is not the overarching sustainable impact we are looking for.

So, then why do we collaborate with the likes of food-parcel orgs? Those type of collaborations are a part of broader holistic projects that also address the determinants of rural-urban migration and food security issues to include agricultural solutions such as local food gardens for example. Bringing food parcels into the project has the goal of strengthening our in-roads, trust and ties with the community in order to help achieve the primary aim of the project: sustainable change.

Engaging food parcel organizations is just an example of how Humble Smile leverages existing initiatives to allow our expert staff to concentrate on their work within our sustainable workflow.

Humble Smile’s global team members, therefore, are paid to provide professional services not being done by anybody else, and include: assessing the needs and assets of the community; designing appropriate scalable health promotion models; forming the necessary collaboration, and; ensuring best support provision for the community.
Those services consist of a very wide array of professional tasks: from data, research, monitoring and evaluation, to; building local capacity for implementation of innovative health interventions.

Communal development is multi-disciplinary. Pursuing sustainable social, environmental, health, and economic development goals requires professional attention to each discipline. A non-holistic approach will usually result in very short-term outcomes. I have witnessed huge investments achieving “impact” that lasted for, literally, hours if not minutes.

Moreover, well-intentioned initiatives focussed on one area of development can damage another area of development.

A case in hand is TOMS shoes. Blake Mycoskie founded TOMS Shoes in 2006 based on the One-for-One business model whereby for every pair of shoes sold in the Global North, a pair of shoes was donated to a child in the Global South. However, from 2014 studies began to emerge that showed “harmful effects and economic decline in local production in the target countries”. By 2019 TOMS was no longer owned by Mycoskie, and the one-for-one model had been replaced with impact grants to professional organizations.

Projects in under-resourced communities that are implemented directly by corporates (such as with distribution of in-kind donations) often run the risks of unprofessional implementation due to issues such as white-industrial-saviour complex, un-sustainable impact, local regulative non-compliance, in-equitability, harming local economic development, and so on… Humble Smile operates according to evidence-based guidelines set by global professional institutions with which we are not only up to date, but are sometimes called upon to contribute our knowledge.

Helping vulnerable communities in the most holistic, responsible, effective, efficient, scientific, sustainable and sensitive way, is the core of Humble Smile’s purpose.

How We Cut Costs

So far I explained how Humble Smile leverages specialized organizations by connecting them to communities in need as part of holistic collaborations. Now let’s look at some of the other ways we manage to limit our budget to human resource expenses.

Often both the beneficiary and the donor intuit that the solution to a need is a costly product or service – tooth decay is rampant, there are no dentists, so a mobile dental unit will solve the problem. Often our assessment of the community’s needs, assets, resources and disease pattern, will point to a more effective and relatively in-expensive solution. Disease prevention by regulation of the marketing, sale and use of smoking or high-sugar nutritional products, for example, is always going to be much more cost-effective than managing the disease with pharmaceuticals or hospitalization. Despite the prevention-rather-than-cure paradigm being quite obvious; in reality preventive interventions require a great deal of time and effort. That’s because behaviour is difficult to change, and commercial forces can be very powerful. Our job at Humble Smile is to direct efforts (and counter-efforts) and that is done by hard-working and unrelenting professional personnel. Here are some ways we promote healthy living without incurring too many non-HR expenses.

Building the capacity of local personnel. These days training and guidance can be done effectively on-line. For example local people with no advanced education can be trained to become Health Promoters or Community Health Workers and provide preventive health services within their community which may be communities that are so remote as to having no healthcare system in place. Modules for Health Promoter trainings are constantly being added by the Humble Smile team, and these are modified for each and every cohort in each and every location.
Another example of cost-effective capacity building is our Gogos Give Smiles project. The gogos are the grandmothers in Southern Africa, and they play a very significant role in their communities. Due to the effects of poverty, substance abuse and disease, with parents working in the cities or having died from AIDS, the gogos have taken on the care of their grandchildren and each other. They take this responsibility very seriously and command the highest respect in their communities. They are also self-organized into social clubs. Humble Smile has partnered with the gogos, at first working with them to understand and articulate their mission, and then supporting the gogos with tools to facilitate and strengthen them on their mission. Gogos Give Smiles is a beautifully holistic project that has all the hallmarks of an ethical, responsible and scalable initiative with the potential to inspire non-African communities in regard to attitudes to the elderly. We manage this project with negligible non-HR costs.

Advocacy. The advantages of upstream interventions have been presented in another blog whereby I established that the further upstream the interventions – the greater the impact.  Intervening at social, commercial and environmental levels will have a higher impact than working with an individual community, and even more so than with individual patients. The greatest opportunities for high impact lie even further upstream with advocacy for improved policies and regulations – the higher the governmental level, the greater the impact. To date Humble Smile has converted a multitude of schools to health-promoting schools and contributed to outcomes on national policy levels in 3 countries (Cambodia, Mozambique and Belize). The beauty of advocacy is that while it is very time-consuming and requires a lot of work including the demonstration of live field models and the generation, processing and presentation of data; the non-personnel related expenses are low.

Offices. What offices? We all work from home. Our laptops might need replacing every 7-8 years or so.

In-kind donations. Products donated by our corporate sponsors are welcomed by our target communities, to the point where the products often serve Humble Smile as a carrot (according to the stick-donkey-carrot metaphor) to introduce other less intuitive (from the communities’ point of view) interventions. As mentioned above, we ensure in-kind donations are distributed equitably and with sensitivity to the local culture and economy.

Promotion. Promotion is an integral part of our mission to share Humble Smile’s deepening pool of knowledge. The CSR model of funding also requires promotion of our work so the companies get the publicity they deserve. Thankfully these days there are many ways to use online platforms to share posts, videos and newsletters for free.