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The Nurses Apron Partnership

Microfinance 101

Posted: 16 March 09

Part One: So Much for So Little by Ginger Manley

In 1989 I resigned from my secure position on the faculty of a university school of nursing to pursue my dream of owning my own nurse-psychotherapy practice. I had two children in college and was expected to be the co-earner in my marriage. Looking back, I should have been too scared of the risks to do this but it was a dream I had nurtured within me for almost eight years and one that I felt quite prepared to fulfill.

For four years I had been running the kind of practice in the medical center that I envisioned having in a private setting. I had a six-month waiting list of patients wanting to get appointments with me and a referral base of about 250 miles circumference. I had met the minimum quota to support my salary for the previous two years and substantially exceeded the quota for the last year. I had a group of fellow psychotherapists who had invited me to join their group and they had rented space in a new office suite that was about to be built out. But I needed $5,000 for operating costs to get my business open and none of the banks to whom I spoke would loan that amount to me, not because I was a bad credit risk or that I couldn’t show them meticulous paperwork documenting all my financial know-how. Not because they discriminated against women business owners. No, they wouldn’t loan to me because I was asking for too little. They could easily loan me $25,000 or $50,000, but no one had ever borrowed just $5,000 to start a small business and they couldn’t help me.

My mother had been widowed suddenly at mid-life while I was in college. She had never worked outside the home and had no basic job preparation but she had been the recipient of kindness from a local businessman who put her to work after my father’s death doing menial tasks in his department store. In 1989 she was still working there, in her late sixties, now as assistant to an administrator. She had self-esteem and income but she didn’t have much cash in the bank. Despite this she stepped forward and loaned me the $5,000 and I opened my practice in July 1989. Five years later I had repaid her the $5,000 principle plus interest and it was the last loan I ever needed. My business was self-sustaining until I closed it in 2005 when I retired. I knew at the time I started my business that I was an entrepreneur—in fact I used the term nurse-entrepreneur to describe myself—but I didn’t know then that my business was a microenterprise and that I was a beneficiary of microcredit. I only put those latter words together in reference to my business two weeks ago when I attended a conference in Nashville sponsored by the Vanderbilt Institute for Global Health.

Microfinance, which encompasses microcredit and microenterprise, has been changing the world one small business at a time since 1977, when Dr. Muhammad Yunus, an economist, started the Grameen Bank in Bangladesh to loan tiny sums of money—sometimes as little as $10—to groups of self-employed village women to help lift them out of poverty. The group members guarantee one another’s repayment and when one loan is paid another woman can request a loan. Dr. Yunus was awarded the Nobel Peace prize in 2006 for his world-changing experiment. Since 1977, microfinance has been implemented in almost every developing country in the world.

Simplified, microfinance consists of a microcredit organization, a donor or donor group, and a qualified microloan cooperative. The microcredit organization is usually a not-for profit entity which does due diligence on site where the microcredit is to be extended. The microcredit organization finds self-employed people who are already successfully doing whatever the business may be—delivering meals on bicycles, making salsa to be sold on the roadside—and loans them small amounts of money so they can grow their business. As the business grows and the loan is repaid, money becomes available for them to re-borrow or for others in the locale to borrow. This is called a nurture investment—or in some cases bootstrapping. These microenterprises ultimately nurture community-wide development one entrepreneur at a time.

The donor can be a single individual who wants to promote bootstrapping or it can be a group of donors that target a specific cause. The donation process is a little like what happens in the U.S. with United Way campaigns in which one can donate to the organization in general or can target a specific United Way sponsored entity.

Usually the donated money is transferred by the microcredit organization, either by hand or if a credible banking system is in place in the recipient’s locale, to a community cooperative that usually has from eight to twenty or more members. In most situations these groups must be accredited by the federal government in that country and must abide by strict accounting and transparency guidelines. In the more than thirty years of experience with microcredit and micro lending, more than 98% of the loans have been paid back, always with interest which reverts to the group. Group members often contribute something of their own money which is co-mingled with donated money, thereby giving the members ownership of their cooperative, a little like the concept of credit unions in the U.S.

While the bulk of microfinance has been aimed at women, there are also successful programs involving men. Microfinance has been implemented across ethnic and cultural lines, and it has been successful not only for the role of bootstrapping new businesses that contribute to community development but even more so for improving health and quality of life and for building alliances across continents, religions, and among the huge variety of humanitarian organizations at work worldwide.

There are a variety of microcredit organizations today, some as small as a few people and some with many thousands of donor/investors. In the last five years, KIVA.org www.kiva.org has become the best-known person-to-person microlending program, allowing potential donors to target specific businesses or types of individuals with the click of a computer mouse. If a donor or group of donors in, for example, Chicago, wants to target “grocers” in Tanzania, they can use the search engine and see a profile of all grocers in Tanzania who need a microloan. Then with a few clicks, the donors can designate their targeted choice and submit an amount and soon after, they receive an acknowledgement of their gift.

I knew most of this on an intellectual basis before I attended the Global Health Summit but I did not get it in my gut until I sat that day among the audience of people who are on the ground in Zimbabwe and Haiti and Ecuador and Sierra Leone and countless other spots around the world making a difference one microloan at a time. I heard microcredit expert Eric Thurman, former CEO of Opportunity International, and co-author of “A Billion Bootstraps: Microcredit, Barefoot Banking, and the Business Solution for Ending Poverty” (McGraw-Hill, 2007) challenge all of us to be change agents. I heard stories of individuals in places I can barely pronounce who have become business owners and community builders because someone, somewhere invested a few dollars in them. I heard how even the smallest amount of money, by U.S. standards, can help people to buy mosquito netting to prevent malaria or can buy books for schools that were not even in existence five years ago. And I realized how very changed my life had been because someone had invested in my mother and because she subsequently had invested in me. That is the heart of microfinance—it changes the lives of the people who give and of the people who receive.

Poppy Buchanan “got it” more than ten years ago when she began investing in Susan Kaburu, a registered nurse from Kenya, who now owns Samaria Maternity Home, the prototype health care center for that country. Over the past decade Poppy and her friends and families through the non-profit Burning Bush, Inc.(BBI), a microcredit organization based in Nashville, have invested in seven microcredit cooperatives in this Central Kenyan community. BBI funds cooperatives of farmers who sell their snow peas to markets in Europe; cooperatives of grandmothers raising their AIDS orphaned grandchildren and who knit sweaters from yarn they have spun for sale in the U.S.; and cooperatives of private nurses who are the only health care providers in the area and who need continuing education to be current in their field.

Poppy’s work influenced the founding of The Nurses Apron Partnership (TNAP), initially a group of fifty registered nurses but now open to anyone who is a friend or family member of a nurse or anyone who admires what nurses do. TNAP’s mission is to assist nurses to have the resources they need to do the work they do. Our logo apron symbolizes the TNAP motto, “gotcha’ covered,” a phrase which is sometimes associated with the words of a quick-drawing cowboy. In this instance “gotcha’ covered” means providing what is necessary to help others to help themselves.

As I sat in the Global Health Summit and in the days afterward my mind was racing. Eric Thurman told us that one of the characteristics of a change agent is “restlessness” and I identified strongly with that name. I knew that I needed to find a way to move TNAP from where we have been for more than two years—a hardworking group of nurse writers who have contributed to our forthcoming book—Gotcha’ Covered: A Legacy of Service and Protection—to a more involved entity. Our goal from the beginning has been to use the income received from Gotcha’ to fund nurses wherever we can, but that plan is taking a long time to see daylight and we need to take action now.

“You want people to do what?” my friend and colleague responded when I told her I wanted TNAP to become a portal—a doorway—through which people could target nurses needing microloans. “Don’t you know we are in the middle of the worst recession in 75 years and people do not have money to give away?”

“Yes,” I said, “I know all that. But I also know there are nurses who need us, especially those nurses whose stories I have come to know through Poppy and the BBI network. I am only suggesting that each of us contribute a little—pocket change by most of our standards. Maybe as little as $1 a month, but whatever can be given will help a nurse who is depending on us until she or he can make it on her own. TNAP can become the portal—the doorway.”

I told her about Beatrice Kabemba-Bapemacho, a nurse in the DR Congo, who along with four other nurses created the Association of Women Nurses to assist women victims in their country who were infected with AIDS as a result of the horrendous wartime rapes inflicted upon them in the recent catastrophe in that country. These nurses each gave $20 out of a monthly income of $60 to $100, to start a microlending cooperative that gives very small microcredit loans to the women. Click here to read the story.

“Surely if those nurses in the DR Congo who have so little can give something that helps so much, we can do the same.” “I can do that” my friend replied, sighing. “How do I sign up?”

TNAP is not a microcredit organization or a non-profit corporation, although it may become one or both of these someday. TNAP is instead a donor portal—a doorway through which potential donor/investors may pass on their way to targeted nurses in need of a small loan. For now, those targeted nurses are in Kenya, where BBI has been on the ground for years fostering reciprocal relationships, rich with trust and integrity. Eventually TNAP may be well-enough established to target nurses in other parts of the world. Who knows? At least we are on our way.

In Part Two of this update, I will tell you about a special nurse who has been selected to be our first targeted microloan recipient and I will tell you how you can make a difference in that nurse’s life and in the community where she lives!

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