[Congressional Record Volume 140, Number 100 (Wednesday, July 27, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: July 27, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                        LESSONS WITHOUT BORDERS

  Mr. SARBANES. Madam President, last month I had the honor of 
participating in the launching of the U.S. Agency for International 
Development's Lessons without Borders Program series at Morgan State 
University in Baltimore. At that event, city officials, community 
leaders, and USAID professionals came together to initiate a dialogue 
on some of the problems that affect developing countries and U.S. inner 
cities alike, with the goal of sharing methods and solutions.
  The program demonstrated not only that we can learn from the 
experience and creativity born of hardship in other countries, but that 
together we can develop common approaches that result in greater 
benefits to everyone. In areas such as providing preventive health care 
services, making credit available to small mom-and-pop businesses, 
eradicating preventable diseases, and lowering childhood mortality, 
there is much to be gained by taking advantage of some of the cost-
effective and broad-based solutions that have been applied in the 
developing world. By sharing directly the ideas, information, and 
techniques that have been used in their respective areas, community 
service professionals and development experts are multiplying the 
impact of investments in domestic revitalization as well as in 
international development.
  I would like to commend USAID Administrator Brian Atwood, Vice 
President Al Gore, Jr., Baltimore Mayor Kurt Schmoke, and all of those 
USAID and the city of Baltimore who made the June 6 event possible, and 
I would ask unanimous consent that the attached articles about the 
program, along with the Vice President's speech, be printed in the 
Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                        Lessons Without Borders

                      (By Vice President Al Gore)

       I've just come from a ceremony commemorating D-Day. We 
     remember the actions fifty years ago today--not only of the 
     allied soldiers--but also those who sacrificed at home.
       But anniversaries of famous battles aren't just the cause 
     of celebration. For while they remind us of the heroes of 
     freedom and democracy they also remind us of the grim horrors 
     of war--destruction and loss. They make us renew our effort 
     to prevent future wars.
       After WWII, it was the Marshall plan which aimed at 
     revitalizing the economy and communities in Western Europe.
       And it was a success. We helped Western Europe build a 
     self-sustaining system which embodied participatory 
     democracy, protected the free market and unleashed their 
     productive energies.
       And the Marshall Plan's success led to other foreign aid 
     efforts. Like President Kennedy's Foreign Aid Act of 1961 
     which extended aid to Africa, Asia and Latin America.
       He said soon after entering the White House that the 
     developing world is ``The great battle ground for the defense 
     and expansion of freedom.''
       Since that time, we have learned many lessons in our 
     efforts to aid developing nations. Lessons about housing, 
     nutrition, vaccinations, prenatal health care and disease. 
     Now it's time to bring the lessons we have learned abroad 
     home, for these are ``lessons without borders.''
       That's why we're here today. To continue a dialogue between 
     development experts and those here at home who are working to 
     solve economic and social problems in the United States.
       I am particularly pleased that USAID has taken the lead on 
     this.
       Under Brian Atwood, the Agency has taken on the task of 
     redefining its mission to meet the needs of the post-Cold War 
     world. USAID has been a leader in the program I chaired, the 
     National Performance Review, and it has made itself an 
     official reinvention laboratory.
       Those who may think reinvention is just another word for 
     shuffling around bureaucratic boxes should look at what USAID 
     is doing here. Since the Foreign Assistance Act became law 
     thirty-three years ago, thousands of Americans have become 
     involved in the rebirth of nations. They're agricultural 
     experts, advising on soil conservation, cattle breeding and 
     crop management.
       They're teachers--helping communities establish schools 
     where children are now learning to read, and technical 
     facilities, where adults learn the skills they need to 
     compete in a changing world.
       They're water and waste experts, helping to set up clean 
     water supplies and develop efficient, affordable ways to 
     recycle waste.
       They're public health officials--setting up clinics where 
     expectant mothers and their children can receive health care, 
     and whose effect is felt long after they have left.
       They are precisely the kind of people who can help us solve 
     problems within our borders.
       Whether it's developing vaccine programs in Mali and 
     Manhattan, or treating dehydration in Bangladesh and urban 
     areas in the U.S. such as right here in Baltimore, some 
     lessons are universal.
       Let me give you some examples:


                             immunizations

       A few weeks ago we recognized Immunization Week at the 
     White House. We pledged to keep working on developing new 
     immunization strategies until children cease to die 
     needlessly from diseases which are easily prevented.
       In 1990, only 39 percent of inner city children in the 
     United States were immunized against measles.
       In Mali, infant mortality rates are among the highest in 
     the world: over two-thirds of childhood deaths could be 
     prevented by vaccination.
       The University of Rochester is currently working in 
     partnership with the Columbia University in Mali to improve 
     child immunization levels among the poor, urban populations.


                              dehydration

       Dehydration kills 3 million children every year. In the 
     United States it kills up to 600 children and hospitalizes 
     thousands every year.
       USAID has found that feeding children a mixture of water, 
     sugar, and salt prevents diarrhea from causing dehydration. 
     This treatment costs pennies a day.
       It now saves more than 1,000,000 lives a year.


                            social marketing

       USAID is using marketing techniques all over Africa, much 
     like Colgate toothpaste, to ``sell'' socially important 
     products like condoms, or messages stressing the importance 
     of breastfeeding.
       They pretest, package and promote the materials and launch 
     the products just like a business would. This cause-related 
     marketing is another example of something we can use within 
     our borders.


                        community based services

       USAID identifies credible people within the community and 
     forms a network between these groups--in places like Kenya, 
     Nigeria, Guatemala and El Salvador.
       The groups then serve as actual service providers--going 
     door to door to identify children with diarrhea or pregnant 
     women. They then pass along their knowledge so the people can 
     ``help themselves.'' This is an excellent example of 
     community empowerment and we can use this same idea right 
     here at home.


                            pest management

       Alley farming is a technique used in Nigeria to control 
     crops without pesticides.
       Rapidly growing trees are planted in bean fields, becoming 
     an artificial host for parasites. The beans are allowed to 
     grow quickly. The Nigerians then plant corn, and the pests 
     feed on the beans. We can use this cheap, environment-
     friendly technique in Georgia and the Carolinas.


                      microenterprise development

       Credit and loans are now within reach of the poor.
       A commercial bank in La Paz, Bolivia now gives loans solely 
     to low-income people. The average loan is about $400. This 
     bank makes more loans than the entire banking sector in 
     Bolivia combined.
       In the United States, there are 200 microenterprise 
     programs just getting started--and here's a technique that 
     can help.
       The underlying solution we see from these examples is 
     cooperation. Development comes from communities and 
     individuals working together. It is a natural outcome of 
     empowerment.
       The community activists in this room know all too well that 
     the problems on the table are severe and require considerable 
     personal responsibility. But they also know that they are 
     made worse by hopelessness.
       The mother who doesn't get prenatal care, who doesn't know 
     about nutrition or when to have her children immunized--her 
     situation is made worse by a feeling of powerlessness.
       The young man who wants honest work but lacks the means to 
     start a business--his situation is made worse by a reasonable 
     lack of hope.
       We can't ``develop'' people, or make them assume 
     responsibility for their own lives if they don't want to. 
     This is as true here as it is overseas.
       But we also know that we can use cooperative approaches to 
     give people a sense of control over their futures--that they 
     matter as positive contributors to society--not just as 
     victims.
       The federal government has a role to play and that's the 
     basis of our community empowerment program. But the 
     government can't do everything.
       This is why I'm especially eager to see programs of 
     microenterprise and community banking flourish in our poor 
     neighborhoods. In developing countries, these programs have 
     given tens of thousands of poor people the means to begin 
     small, informal businesses that give them the strength to 
     live lives of purpose and hope.
       In neighborhoods where no one is literate--in homes where 
     most infants are expected to die--in nations torn by violence 
     and hunger and despair. Yet even in such environments, they 
     have learned how to bring hope.
       Now they're bringing those lessons home.
       As the programs of Accion International and FINCA have 
     demonstrated in Latin America, the real strength of 
     microenterprise and neighborhood banking is empowerment at 
     the grassroots level. It helps people take control of their 
     own lives. It creates bonds among strangers. It helps to make 
     a neighborhood from a bunch of buildings.
       USAID, along with other development agencies and private 
     voluntary organizations have learned how to achieve things in 
     environments that have few resources, if any,
       It reminds me of an old story about the business man who 
     went to the oracle and said his abacus counters couldn't keep 
     up with the workload--but couldn't afford to hire any new 
     workers. What should he do?
       ``Each abacus counter must grow another finger on each 
     hand,'' said the oracle.
       ``That's very wise,'' said the businessman. ``But how do I 
     get them to do that?''
       ``Ah,'' said the oracle. ``I only make policy. Implementing 
     it is your job.''
       We must remember that when it comes to implementing--we all 
     have a role to play whether in the public or private sector, 
     or through volunteer groups.
       Eric Sevareid once told President Kennedy that:
       ``It doesn't make much sense when two people are sitting in 
     a boat for one of them to point a finger accusingly at the 
     other and say `your end of the boat is sinking.'''
       We know that we are all in the boat together. Only together 
     can we formulate solutions which will put an end to poverty 
     and ensure economic and social freedom for all--both 
     overseas, and in our neighborhoods.
       The time and opportunity are upon us. It's always been easy 
     for Americans to lend a helping hand, but far more difficult 
     to accept one.
       On this day when we remember how Americans lent a helping 
     had to Europe, let's dedicate ourselves to a continuing 
     effort abroad, but also renewing our commitment within our 
     own borders.
       Yet here we are--truly helping ourselves--bringing the 
     lessons we've paid for to our own doorstep. It is a hard 
     path, but a necessary one. can traverse it best by traveling 
     it together.
                                  ____


               [From the Washington Post, June 11, 1994]

                         Foreign Aid Comes Home

       The ``Lessons Without Borders'' program launched by Vice 
     President Gore in Baltimore this week is supposed to be a 
     winning proposition for all. The idea, generated by the U.S. 
     Agency for International Development, is to bring to 
     America's poor communities some of the lessons AID has 
     learned while operating programs in the developing world. 
     Baltimore Mayor Kurt Schmoke volunteered his city to be AID's 
     opening act. His reasons for doing so were candid and telling 
     about America today.
       ``It is an unfortunate fact of life,'' said Mayor Schmoke, 
     ``that we have in certain parts of our city health problems, 
     housing problems, that resemble those in Third World 
     countries.'' Those words, could have been spoken by any big-
     city major in America.
       The similarities of conditions in the developing world and 
     American inner cities and rural communities are mortifying. 
     There are poor neighborhoods around the country with infant 
     mortality rates that rank right up there with countries where 
     Peace Corps volunteers and American aid workers are being 
     dispatched to work. We think of children who die from 
     diarrhea as being only found in countries like Bangladesh or 
     Burkina Faso. In America's inner cities and in rural 
     communities, however, hundreds of our own children are dying 
     or being hospitalized each year from disease.
       Vice President Gore noted that only 39 percent of inner 
     city children were immunized against measles in 1990. Stack 
     that up against poverty-ridden Egypt, where AID reports a 90 
     percent immunization rate, or India's 80 percent or the 88 
     percent immunization rate achieved in the Philippines. The 
     sad fact is the some of what ails the most devastated 
     countries on earth also afflicts communities within our own 
     borders: illiteracy, poor nutrition, little or no prenatal 
     care, disease, joblessness and, ultimately, hopelessness.
       The Agency for International Development can't be expected 
     to solve problems on American soil; the law prevents AID from 
     doing that. But perhaps the agency--take a page from the 
     developing world--can lend a helping hand by advising hard-
     pressed U.S. communities how they can use techniques from the 
     Third World to address their own problems. After decades of 
     work abroad, AID has learned many lessons. This experiment 
     can usefully teach Americans another lesson: Images of Third 
     World deprivation are universal; they can be even found on 
     U.S. soil.
                                  ____


                        [From the Baltimore Sun]

                      Lessons from the Third World

       For more than three decades, the United States has been 
     sending small armies of people to poor countries to aid 
     economic development efforts. Now, when Americans have plenty 
     of reason to be concerned about their own economic well-
     being, many voters are beginning to look askance at the money 
     spent on foreign aid. The partnership inaugurated this past 
     week between Baltimore and the U.S. Agency for International 
     Development is aimed at finding ways to apply the lessons 
     learned in development efforts overseas to some of America's 
     urban ills.
       The lessons abound: Haiti may be poor, miserable and 
     desperate. But in many areas it does better in immunizing its 
     children against common childhood diseases than some parts of 
     Baltimore. Could we learn something from their approach?
       Bangladesh also has enormous misery and deprivation. But 
     through its innovative Grameen Bank it has found a way to 
     provide capital to millions of poor people, particularly 
     women. In this country, poor people are caught in a credit 
     bind, vastly limiting their ability to capitalize on their 
     own initiative. Without money or other assets, it is hard to 
     qualify for a loan.
       The Grameen Bank has found that loans of even $10 and $20 
     enable women to invest in spinning wheels or other equipment 
     necessary to begin very small businesses, or ``micro 
     enterprises.'' By helping these people tap into their own 
     energy and initiative, the bank enables them to magnify their 
     household income and improve their family's standard of 
     living. Programs modeled on the Grameen Bank have given 
     similar chances to poor people here; how can we expand these 
     efforts?
       Anyone familiar with the lives of very poor people, whether 
     in inner cities or rural areas, knows their problems 
     transcend national borders. Their problems reach far beyond 
     the daily challenge to maintain adequate food and shelter. 
     From unanticipated pregnancies, infant mortality and 
     unhealthy children to lack of jobs or no access to credit, 
     the problems of poor people in Maryland look a lot like those 
     faced by the poor elsewhere in the world.
       It is refreshing to see that a federal agency charged with 
     funding development programs in other countries can also 
     recognize the importance of finding ways to share what it 
     learns with people in this country. That not only enriches 
     efforts to help poor Americans; it also helps to inform 
     taxpayers about the vital role foreign aid can play in a 
     dangerously unstable world.
                                  ____


                 [From the Baltimore Sun, June 6, 1994]

                 Baltimore to Try Third World Remedies

                            (By Scott Shane)

       For decades, the U.S. Agency for International Development 
     has sent Americans into the Third World to attack the 
     problems of developing countries: infant mortality and 
     childhood illness, unplanned birth and sexually transmitted 
     diseases, poverty and chronic unemployment.
       Now AID wants to teach at home what it has learned abroad. 
     In Baltimore and elsewhere, the agency wants to share 
     remedies for the ills of urban America--infant mortality and 
     childhood illness, unplanned births and sexually transmitted 
     diseases, poverty and chronic unemployment.
       Because Mayor Kurt L. Schmoke put aside boasterism and 
     responded to AID's offer with a candid acknowledgment that 
     the city needs help. Baltimore is the first U.S. city to be 
     targeted by AID's ``Lessons Without Borders'' program.
       It is an unfortunate fact of life that we have in certain 
     parts of our city health problems, housing problems, that 
     resemble those in Third World countries.'' Mr. Schmoke says. 
     ``And, if there are some techniques that AID has used 
     overseas that can be used here. I'd like to apply those 
     problem-solving techniques.''
       ``Lessons Without Borders'' will debut today with a 
     conference at Morgan State University that will bring 
     together Baltimore officials and staff members from AID, the 
     major distributor of foreign aid. Vice President Al Gore will 
     be the keynote speaker.
       By law, AID is not permitted to fund programs in the United 
     States. But, by offering advice and cheerleading, the agency 
     is seeking to be midwife at the birth of a new generation of 
     U.S. social programs.
       AID officials acknowledge that they hope ``Lessons Without 
     Borders'' will help them sell skeptical American taxpayers on 
     the value of foreign aid. But, budgetary motives aside. 
     American specialists in Third World development say the 
     initiative is a long-overdue recognition that creative 
     programs being used to attack stubborn social problems in 
     Africa, Asia and Latin America could be useful on U.S. soil.
       Whether it is immunizations in Haiti--where in some 
     desperately poor neighborhoods the rate of childhood 
     inoculation is far higher than in Baltimore--condom 
     distribution in Central Africa or small enterprise 
     development in Bangladesh. Third World social programs have 
     much to teach U.S. policy makers, say Americans who have 
     worked abroad.
       ``A lot of us who've worked overseas have been waiting a 
     long time for this to happen,'' says Julie Convisser, who 
     runs an AIDS preservation project in Portland, Ore., based on 
     a similar effort in Zaire. ``As Americans we sometimes 
     believe no other country has anything to teach us. We're 
     wrong.''
       Portland's Project Action, the first U.S. effort of 
     Population Services International, which operates in 24 other 
     countries, is among a handful of successful transfers of 
     Third World programs to this country. In Zaire, the battle 
     against AIDS incorporated television soap operas promoting 
     safe sex and condoms on sale for 2 cents apiece in every 
     roadside bar or shop. In Portland, Project Action has 
     produced MTV style television shows for adolescents and 
     placed 185 vending dispensing condoms at 25 cents each, Ms. 
     Convisser says.
       ``Lessons Without Borders'' was born of a conversation late 
     last year between AID Administrator J. Brian Atwood, 51, who 
     was a few months into his job, and Marian Wright Edelman, the 
     longtime head of the Children's Defense Fund.
       As Mr. Atwood described AID's work abroad and Ms. Edelman 
     recounted disheartening statistics on child health and 
     poverty in the United States, they saw an opportunity, Mr. 
     Atwood said last week by telephone from Geneva. He was 
     returning from a tour of African famine areas undertaken at 
     the request of President Clinton.
       In a November appearance on C-Span, Mr. Atwood said, he 
     ``blurted out'' the idea that AID hoped to consult with U.S. 
     cities. Among the viewers was Schmoke aide Lee Tawney. He 
     passed the word on to the mayor, who decided Baltimore should 
     be part of the collaboration.
       Mr. Atwood said AID has not previously sought to apply its 
     expertise in the United States partly because the agency long 
     felt beleaguered, a pawn in superpower politics that came 
     under fire for dubious spending.
       ``During the Cold War, we did waste a lot of money to buy 
     influence overseas,'' Mr. Atwood said.
       The agency's budget peaked in the early 1980s at about $12 
     billion, much of it directed to fighting communism in Central 
     America and elsewhere. Today, the budget may be less 
     vulnerable to political pressure to steer the aid to allies, 
     but it is down to $7 billion. ``Lessons Without Borders'' 
     could protect that spending by providing visible evidence to 
     Americans of the effectiveness of programs developed by AID.
       Other developments make AID's initiative timely, public 
     health experts say.
       The debate over health care reform has given new urgency to 
     cutting medical spending and one way to do it is to get away 
     from the high-cost approach traditional in this country.
       ``We Americans like the idea of being rushed to a high-tech 
     hospital,'' says Dr. William B. Greenough III. professor of 
     medicine and international health at Johns Hopkins. ``A great 
     many things can be done at lower cost and with equal efficacy 
     in the community and not in the hospital. In countries with 
     very limited resources, you have to save the patient and save 
     money at the same time.''
       A striking example is treatment for dehydration caused by 
     diarrhea, says Dr. Greenough, who worked for eight years in 
     Bangladesh before returning to the United States in 1985.
       For many years, doctors in Third World countries have 
     treated the condition with ``oral rehydration therapy'' a 
     packet of a few cents worth of salts and sugars that can be 
     mixed with water and drunk by the patient. If such a packet 
     is not available, chicken and rich soup is a fine substitute, 
     as Hopkins physicians have long pointed out
       Yet the United States severely dehydrated patients 
     generally are hospitalized and hooked up to an intravenous 
     drip at a cost hundreds of times greater than the low-tech 
     alternative. Indeed, because diarrhea is dismissed as a 
     triviality, Dr. Greenough says, it often goes untreated, 
     leading to many unnecessary deaths, particularly among 
     nursing home patients.
       Remedies that can be administered at home ``lack TV 
     appeal'' and are not considered real medicine by Americans, 
     who have an almost superstitious belief in costly machinery. 
     ``Basically, our witch doctor's mask is a lot more 
     expensive,'' says Dr. Greenough, who welcomes AID's push to 
     bring in low-tech methods.
       Elizabeth Holt, an assistant professor of international 
     health at Hopkins, is another public health professional who 
     has worked on both sides of the great divide between domestic 
     and international programs: in a poor urban community outside 
     Port au Prince, Haiti, and in Baltimore and elsewhere in 
     Maryland.
       In the Haitian community, Dr. Holt says, the rate of 
     complete immunizations by 1 year of age reached 85 percent in 
     the late 1980's. In Baltimore, while nearly every child is 
     immunized by school age, the rate at 2 years of age is only 
     55 percent, says Dr. Peter Beilenson, Baltimore's health 
     commissioner.
       The problem, Dr. Beilenson says, is not a shortage of 
     facilities for immunization and other preventive care. It's 
     the failure of people to take advantage of what's available. 
     That's why Baltimore's Healthy Start program, which seeks to 
     reduce infant mortality and the incidence of low birth-weight 
     babies, hires community residents to do outreach work, 
     identifying pregnant women and bringing them in for early 
     prenatal care.
       Healthy Start may have something to teach AID, says 
     Margaret Neuse, deputy director of the agency's office of 
     population. ``Lessons Without Borders'' should be a two-way 
     street, she says.
       In Latin America, Africa and Asia. Ms. Neuse says, she has 
     faced difficulty in getting people to use health services. 
     ``I just came back from a place in Ethiopia with a population 
     of 30,000, where a program serves just 10 clients a day. We 
     had a case in Nepal where you couldn't pay women enough to 
     get them to go to a clinic.''
       Joe Bock, a former Missouri legislator who has worked for 
     two years for Catholic Relief Services, says he sees great 
     potential for transfer of programs outside the area of health 
     care to U.S. soil.
       Many programs in the U.S. war on poverty have ``failed 
     miserably.'' says Dr. Bock, who will soon take over Catholic 
     Relief's operations in Pakistan. ``We're looking around for 
     new ideas.''
       One such idea, he says, is what development professionals 
     call microenterprise: tiny, family-based businesses started 
     with minimal capital. The Grameen Bank (``rural bank'') of 
     Bangladesh, which has served more than 1 million poor women, 
     has inspired a number of fledgling U.S. programs.
       As the United States grapples with welfare reform, 
     microenterprise offers an alternative approach to fighting 
     poverty, one based on poor people becoming small-time 
     entrepreneurs rather than cashing monthly checks.
       ``Unfortunately, we've had the idea of the U.S. riding in 
     as a knight in shining armor to teach these countries.'' Dr. 
     Bock says. ``In fact, we can learn a lot from what they're 
     doing.''
                                  ____


                 [From the Baltimore Sun, June 7, 1994]

                 Gore Launches U.S. AID's Help for City

                          (By Richard O'Mara)

       Vice President Al Gore launched a partnership yesterday 
     between Baltimore and the U.S. Agency for International 
     Development designed to apply here the agency's expertise in 
     helping people mired in poverty.
       Speaking at a conference titled ``Lessons Without 
     Borders,'' at Morgan State University, the vice president 
     referred to the efforts of the tens of thousands of health 
     workers, literacy teachers and small business advisers sent 
     abroad since 1961 to focus America's attention on the plight 
     of the Third World.
       ``It is time to bring this knowledge back home,'' he said.
       ``The idea might sound strange but it's not,'' he added. 
     ``Whether developing a vaccination program in Malawi or 
     Manhattan, some lessons are universal.''
       The partnership is the first of its kind, but other 
     cities--Chicago, Atlanta, Boston--have expressed interest in 
     drawing on AID know-how.
       J. Brian Atwood, AID adminsitrator, said, ``It is people 
     like those in Baltimore who invested in the foreign aid 
     programs. Why shouldn't they benefit from it?''
       The suggestion by Mr. Atwood, made on C-Span television 
     late last year, was seized upon by Mayor Kurt L. Schmoke.
       The vice president spoke to about 250 health and 
     socialworkers and community activists at the Morgan 
     conference, plus as many guests.
       After that he visited the Family Place on Ashland Avenue--
     which provides services to needy families, such as literacy 
     training, prenatal care, nutritional information and 
     vaccinations--and was shown around an immunization bus that 
     roams Baltimore's neighborhoods inoculating children.
       At Morgan State, Mr. Gore pointed out that in 1990, only 39 
     percent of American children were immunized against measles. 
     (In Baltimore, fewer than half the city's two-year-olds are 
     up to date with their immunizations, said Charlotte Crenson, 
     a city health program adminsitrator, who was on hand for the 
     vice presidential visit to East Baltimore.)
       Because of AID's skills abroad at propagating the 
     importance of inoculations, a lot of developing countries are 
     doing much better in immunization, he said.
       AID marketing techniques also are effective at spreading 
     the word in foreign countries about the protection against 
     infant illness that breast feeding provides.
       The agency encourages and underwrites banks in Third World 
     countries to lend small amounts of money to poor people who 
     have no collateral, but do have an idea for a business, or 
     ``microenterprise,'' Mr. Gore said.
       AID also trains and deploys local community volunteers to 
     assist professional health workers and community activists 
     abroad.
       The vice president called the use of volunteers ``an 
     excellent example of community empowerment, a technique we 
     can use here. Something developed to help nations elsewhere 
     can help here.''
       And the reverse can be true. Baltimore can teach AID a 
     thing or two, agency officials said. For example, workers at 
     Healthy Start, a prenatal care program, have devised 
     strategies for dealing with substance abuse among the people 
     it helps.
       Healthy Start was founded in 1990 to help lower infant 
     mortality rates in certain Baltimore neighborhoods that had 
     reached Third World levels--19 deaths per 1,000 live births 
     in Harlem Park and the area around Johns Hopkins Hospital, 
     according to Daisy Morris, who runs Healthy Start.
       ``When we began we found that substance abuse was a 
     tremendous problem, between 30 and 35 percent of [expectant] 
     moms'' had it, Ms. Morris said. The experience in dealing 
     with this, Ms. Morris believes, is ``what gave us the edge on 
     a lot of cities, because we understood our moms.''
       Margaret Neuse, deputy director of AID's Office of 
     Population, who has visited Healthy Start, said, ``We have a 
     lot to exchange with Baltimore. We have met different 
     problems.''
       Everyone who addressed the Morgan State conference stressed 
     that the partnership would be more than a rhetorical one, a 
     friendly gesture from a Democratic president to a political 
     ally in a nearby city. They insisted this was the case even 
     though AID is prohibited by law to operate within the United 
     States.
       Other speakers included Mr. Atwood; U.S. Sen. Paul 
     Sarbanes, a Maryland Democrat; and U.S. Rep. Kweisi Mfume, D-
     7th District.
       Mr. Atwood announced that a working group would be set up 
     with representatives from AID and the city to decide on 
     reasonable expectations for the partnership.
       Mr. Slater listed several likely AID initiatives. It would 
     send field directors just returned from abroad to Baltimore 
     to lecture and hold seminars; provide access to AID's 
     enormous library to Baltimore health and nutrition workers; 
     create internships for social workers from the city; and send 
     people in the local helping professions to visit foreign 
     development programs. Later in the day, Mr. Gore went to the 
     Social Security Administration headquarters in Woodlawn and 
     continued a theme that he raised at Morgan State: the benign 
     intervention of government.
       ``Twenty-five or 30 years ago, more than 70 percent of the 
     American people felt that government would do the right thing 
     in solving national problems. Now only 20 percent believe 
     that,'' he said.
       ``We have to put the customers (citizens) first,'' he 
     emphasized.

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