Kissito Position on Climate Change

The National Aeronautics and Space Administration (“NASA”) and the National Oceanic and Atmospheric Administration (“NOAA”) have both concluded through independent analysis 2013 was the 4th hottest year on record. In fact, 9 of the 10 warmest years on record globally have occurred since the year 2000. NASA indicates atmospheric carbon dioxide is at its highest level in 800,000 years having risen from 285 parts per million (“PPM”) in 1880 to over 400 PPM currently. Ocean Temperatures, Sea Levels, and Glacial Records: all indicators which track long-term variation support the absoluteness of a Changing Climate.

Many experts believe the warming of the Polar Regions has led to a shift in the polar vortex causing extreme cold in southern parts of the U.S. and drought in western parts of the Country. Climate Change is expected to worsen over time making it difficult for a consensus response absent a clear and immediate threat.

Climate Change forecasts are difficult to make as we are operating in uncharted waters with an abundance of debate on the cause and effect between carbon dioxide and global warming. As with any serious debate: there will be undisputed facts and actions which are universally agreeable. The warming of the planet is not disputed and most people acknowledge a warmer planet means climate norms will be impacted. These changes will impact people proportionate to their level of development. People in Sub-Saharan Africa will experience food insecurity, malnutrition, and starvation while people in the developed world will experience consumer shortages and cost increases, decreased consumption and economic activity, higher tax rates, and unpredictability in economic and social conditions.

The evidence of increased atmospheric carbon dioxide levels having an impact on the Earth’s temperature and climate are highly certain, but insufficient to adjust economic and social policy at this time. This will change with the persistence of extreme weather, drought, and rising sea levels in the U.S. and EU. Eventually, complacency will give way to alarm, albeit at a point where mitigation alone will no longer be capable of solving the problem. The evidence is so overwhelming humanity would be negligent to not take those actions available to us today. It is in this spirit, Kissito Healthcare is committed to the following steps, not that these actions on their own will produce any great change, but if they serve as a catalyst or model for others to affect change, then we will have become a part of the solution and not the problem:

1. Work to establish non-formal and formal “Environmental Literacy Plans” for grades K-12 in the Commonwealth of Virginia and all 50 States.
2. Promote our Nation’s State and Local Parks as close to home places to engage in healthy lifestyles and create awareness of environmental issues and opportunities for citizen stewardship of the planet.
3. Place 50,000 acres of at-risk land in conservation with public access to promote forest carbon sequestration.
4. Establish capacity totaling 25 megawatts of biomass power generation to promote carbon emissions reductions.

The Future of Caring For Our Elders

Nursing homes came into existence less as a necessity and more as a result of economic incentives. The construction of nursing homes in the United States skyrocketed after Medicaid benefits came into existence in 1965, coupled with low-interest Federal construction financing. Lumber companies and builders quickly became operators of nursing homes, cashing in on every possible angle in the rush to institutionalize our Elders. Federal and State-funded Medicaid now covers the costs of about 60 percent of all nursing home care in America.
Not all States bought into the perverse incentives which contribute to excessive Elder institutionalization. Arizona was the last state (1982) to offer Medicaid benefits and when they did, Arizona was already implementing a robust Home and Community Based Services program of care for the Elderly. Arizona’s alternatives to nursing homes have paid off for the State and its Elders! An Arizona resident age 65+ is half as likely to end up in a nursing home as a person living in Virginia. Virginia institutionalizes 3.5% of its Elders while only 1.6% percent of those ages 65+ live in Arizona nursing homes.

All of this is about to change in the Old Dominion State. Aging baby boomers will be pleased to know Virginia is one of the leading states in America in promoting Programs of All-Inclusive Care for the Elderly (“PACE”) which are designed to dramatically reduce the need for nursing homes. PACE allows nursing home qualified participants to live safe and fulfilled lives at home through a network of community support services. Today there is a statewide network of 14 PACE service areas caring for over 1,000 Virginians. Over 25,000 of Virginia’s elders are still in nursing homes, but PACE is positioned to dramatically reduce this number over the coming years. An added benefit: PACE Costs taxpayers significantly less than traditional nursing home care.

The Roanoke Valley’s first PACE center opened last November in Roanoke County, with a five year plan to serve Elders from Bedford to Blacksburg. Kissito PACE expects to employ almost 500 new employees and contractors, each committed to help an expected 800 Elders avoid nursing home placement. The 50-year boom in nursing homes is coming to an end in Virginia, as we focus on improving the quality of life for our Elders while avoiding the high cost of institutional services.

Intervention Sustainability in Lessor Developed Countries by Tom Clarke

Sustainability is an inherent part of all Development Interventions, but more often than not it is merely an afterthought without any real substance or historical successes. Real Sustainability takes Real Household Income to translate into sustainable development interventions. Not dissimilar from the Developed World, people in Lessor Developed Countries must have access to Household Income in order to maintain interventions in Health, Education, Water, Sanitation, and other Development Interventions. Our on-the-ground experience demonstrates people are willing to pay for basic services when Household Income is available. When you are a large Portfolio NGO, you take the $50 Million USAID or DFID Grant, complete your 3-5 year Intervention, and hope for the best. Because Kissito and our close partners are funding our Interventions we constantly focus on Sustainability and generating Real Household Incomes.

Three Kissito initiatives are being designed to employ 31,000+ people in Ethiopia and Uganda and we want these initiatives to serve as Models for creating: JOBS and Economic Activity. Our first and most difficult intervention will engage 10,000 Small and Medium Size (“SME”) farmers in both Ethiopia and in Uganda. Unfortunately, most Ready-to-Use Therapeutic Foods (“RUTF”) are produced in France with Argentinian Peanuts and then air-shipped to African Countries in need. Kissito has invested in RUTF production facilities in Ethiopia and Uganda with the specific intent of creating SME farmer activity and eliminating Toxins from the African peanut supply chain. Difficult…yes… Impossible…Absolutely Not with determination and persistence!

Our Ugandan Improved Cook Stove program is expected to engage 1,000+ people in Stove manufacturing, Maintenance, and Distribution. Kissito and our partners are committed to environmental actions such as Reduce greenhouse gas Emissions from Deforestation and forest Degradation (“REDD”) and Climate change Mitigation and Adaptation initiatives which will engage 10,000+ people in South Sudan and Uganda. The creation of Household Income must raise above all other interventions if we really expect anything to be sustainable without continued donor transferred funding.