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This is an archived USAID document retained on this web site as a matter of public record.
FEBRUARY 2006
In this section:
Rice Links USAID and State Under New Foreign
Aid Chief
Healthcare Standards Rise in Afghanistan
Job Opportunities Remain in Iraq, Sudan
Rice Links USAID and State Under New Foreign Aid Chief
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Secretary of State Condoleezza Rice addresses USAID
employees Jan. 19 in the Andrew Mellon Auditorium.
USAID
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“I just want to say that I think this is going to
be a very important period of time. I need your help. I need
your full dedication to this effort. I am certain that I’m
going to get it because I know how dedicated the men and women
are in this room, and I know that you, too, want the best
for ... our foreign assistance programs, the best for those
who receive our aid and the best for America.”
Randall L. Tobias will be nominated as the new administrator
of USAID, Secretary of State Condoleezza Rice announced during
a Jan. 19 State Department meeting where she also unveiled
a major plan to reorganize the way foreign assistance is administered
by the United States.
If confirmed by the Senate, Tobias would serve concurrently
as the State Department’s director of foreign assistance,
a new position created by Rice to consolidate foreign assistance
programs from USAID, State, and other agencies.
Tobias, currently the U.S. global AIDS coordinator, and a
small staff of USAID and State employees would be based at
State Department headquarters, and he would report directly
to Rice.
“America must get more out of our foreign assistance
institutions,” Rice said in announcing the changes.
She said current foreign assistance efforts are too fragmented
and disorganized, and impede efforts to integrate foreign
assistance with the Bush administration’s overall foreign
policy strategy.
“The current structure of America’s foreign assistance
risks incoherent policies and ineffective programs and perhaps
even wasted resources,” she said. “We can do better
and we must do better. We must align our activities more fully
across the State Department and USAID, and within the State
Department itself. Increasing this alignment will enable us
to be better stewards of public resources.”
She said the new leadership position will transform the
United States’ approach to foreign assistance and “better
align our foreign assistance programs with our foreign policy
goals.”
Just a day before the announcement about Tobias, Rice introduced
a wide-ranging initiative called “transformational diplomacy”
that will restructure how the State Department carries out
its mission. Rice said the objective of the initiative would
be to work with partners around the world to build sustainable
democratic states that respond to the needs of their people.
“Foreign assistance is an essential component of our
transformational diplomacy,” Rice said. “In today’s
world, America’s security is linked to the capacity of
foreign states to govern justly and effectively.
“Our foreign assistance must help people get results.
The resources we commit must empower developing countries
to strengthen security, to consolidate democracy, to increase
trade and investment, and to improve the lives of their people.
America’s foreign assistance must promote responsible
sovereignty, not permanent dependency.”
In a separate event the same day, Rice also told close to
900 USAID employees who packed the Andrew Mellon Auditorium
next door to Agency headquarters that USAID would remain an
independent organization. “I always started from the
premise that USAID would stay intact and it will indeed stay
intact as an independent organization,” she said.
Rice said the changes announced will greatly strengthen
the role of the USAID administrator. The new foreign assistance
director will be expected to guide the development and implementation
of a coherent foreign assistance strategy, including coordination
with the Office of the Global AIDS Coordinator and the Millennium
Challenge Corporation. That person will also oversee budgeting
and program implementation.
The State Department and USAID will also create a new exchange
program under which employees will cross-train between the
two agencies on temporary details.
Several new advanced training courses at the Foreign Service
Institute will also be set up to prepare “diplomats to
manage complicated foreign assistance programs and to think
more creatively about the integration between development,
diplomacy, democracy, and security,” Rice said.
Tobias was tapped to be the first global AIDS coordinator
in 2003 by President Bush. The office is in charge of implementing
the President’s Emergency Plan for AIDS Relief, a five-year,
$15 billion effort to prevent, treat, and care for people
infected and affected by HIV/AIDS in developing countries.
Tobias had been the president and CEO of pharmaceutical giant
Eli Lilly and Company and had also been a longtime executive
with AT&T.
Tobias, who attended Rice’s address at the State Department
briefing, said that “true development” requires
far-reaching changes.
“A fundamental purpose of this reform is, in the end,
to better ensure that we are providing both the necessary
tools and the right incentives for host governments to secure
the conditions necessary for their citizens to achieve their
full human potential,” he said.
Healthcare Standards Rise in Afghanistan
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Habibullah, who uses only one name, has been fighting
heart disease for some time. He has seen the Wazir Akbar
Khan Hospital transform in the past two years through
a USAID project.
Ben Barber, USAID
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KABUL, Afghanistan—With a gruff voice, the gatekeeper
to Wazir Akbar Khan Hospital blocks a man from pushing past
him into the spotless hospital corridors.
“Shoes off,” he says in a no-nonsense voice, handing
the man a pair of plastic sandals and a ticket to identify
his shoes.
A U.S.-funded program run by Loma Linda University Adventist
Hospital has transformed this major trauma and surgery hospital
in the center of Kabul from a nightmare of squalid wards and
filthy corridors into a place where even the very ill find
dignity for their suffering.
Habibullah, who uses only one name, lies back in his bed
with an IV in his arm dripping fluids and medicine to combat
his heart troubles. He is 60 but looks 80 with his wrinkled
face, swollen arms, and wispy white beard.
The former baker has been fighting heart disease for some
time and knows from experience what this place used to look
like before the USAID health project began to upgrade the
hospital.
“I came two years ago,” he said, resting against
a white pillow on clean sheets as his son Ahmed Dada, 21,
sat nearby in front of a small electric heater. “Now
it is so clean, so well-equipped, and so good.”
His son said the old man pays nothing for his care or his
medicine because he is poor. Food is also provided but his
father prefers food from home.
Until recently, most Afghan hospitals were on the level
that might be expected from the country listed as 173rd out
of 178 on the 2004 UN Human Development Index. Just two years
ago, hospitals in the capital, the most developed place in
the country, revealed a shocking scene. Patients lay in their
street clothes on straw mats, filthy mattresses, or soiled
sheets. Dim lighting came from a handful of fixtures that
were not broken. The horrid smell of overflowing toilets and
soiled bandages permeated the air. Patients groaned in pain
and medicine was only given when their families went to the
pharmacy in the market outside and sold their belongings to
buy it.
No more at Wazir Akbar Khan. Aside from cleanliness, hospital
administrator Mike Mahoney has used the $3 million USAID grant
to provide basic medicine; fix or install basic medical devices
such as ventilators, heart monitors, defibrillators, x-ray
and other machines; upgrade the emergency room; and “introduce
changes to bring this up to speed,” he said in his office.
Admitting he’s never worked in a country as poor as
Afghanistan, Mahoney said he is awaiting a container of cleaning
materials to strip and wax the floors so they can more easily
be kept spotless. Reducing infections, gastroenteritis, and
other diseases spread by dirt is key to raising health standards.
He has also brought a team of surgeons who have been teaching
the Afghan doctors in the morning and working side-by-side
with them in the afternoons caring for patients in the 210-bed
institution.
He shows a visitor a list called “essential package
of hospital services” that tells what surgeries and other
interventions the facility should provide to anyone who walks
or is carried in the door of this primary trauma center in
the capital of 4 million.
Mahoney says he is already able to fulfill about 30 percent
of the services on the list and is working on the rest.
Part of the reason for his success is a tough-looking former
mujahideen fighter against the Soviets, Mohamad Ayub, 46,
who is the country director for the project. “He gets
things done,” said Mahoney.
The bearded ex-fighter smiles when he hears this and tells
how he works. “I saw a relative of a patient rushing
out the door with a prescription in his hand,” he says
with a slight smile. “So I grabbed him and said: ‘Stop.
Why do you go out for medicine? We have it here for free.
If you go out, don’t come back.’”
He wants to discourage a return to the old ways when doctors
sent patients out to buy drugs because hospital pharmacies
were looted or simply nonexistent.
To keep its pharmacy up-to-date, the Loma Linda team has
created a filing system that includes patient care and other
aspects of management seen as key to modern organization and
efficiency.
Up on the second floor ward, although Habibullah is clearly
unwell, he reclines on a real hospital bed, in a hospital
gown, lying on clean pillows and sheets in dignity, a new
beginning for medical care in this ancient land.
Job Opportunities Remain in Iraq, Sudan
A number of Agency staffers have recently signed up for posts
in Iraq, Afghanistan, Sudan, and Pakistan—critical priority
countries (CPCs) for 2006. However, a handful of positions
are still open and in need of volunteers in the coming weeks.
The jobs that remain available are regional positions in
Iraq and a controller position in Sudan. The second advertisement
for these positions and other foreign service assignments
is scheduled for release in late January. At that time, there
may be additional jobs in CPCs on which officers can bid.
“We need to continue to try to motivate people to take
on these assignments,” said Rebecca Cohn, chief of the
Personnel Operations Division.
The assignments, while considered hardship posts, do offer
advantages, including career enhancement and increased pay.
Workers assigned to Iraq, for example, receive 25 percent
danger pay; a 25 percent post differential; a 20 percent special
overtime differential; a Sunday differential (only for uncommissioned
officers); two two-week vacations and three one-week regional
rest breaks (RRBs) in a year-long tour; and up to 20 workdays
of administrative leave per year.
People posted to Iraq are also assigned fully furnished,
one-bedroom homes with modern amenities like satellite television.
USAID’s offices within the International Zone (also known
as the Green Zone) are housed in a blast-resistant office
building. While there have been car bombings and other kinds
of attacks in the International Zone since it was created,
no USAID staffers have been killed as a result of the incidents.
Foreign service officers not currently serving in a hardship
post are required to bid on at least one position in one of
the CPCs or in another of the hardship posts, and those jobs
are filled before other foreign assignments are made. The
assignments in Iraq, Afghanistan, and Pakistan run one year
unaccompanied. When the Sudan mission moves from Nairobi to
Juba and Khartoum in FY 2006, it is anticipated that the tour
length will be one year unaccompanied and two years with adult
dependents. The Agency has also been offering foreign service
limited appointments for hard-to-fill CPC vacancies, thereby
broadening the pool of expertise to meet the Agency’s
staffing requirements. And, in some instances, the Agency
has been able to offer extensive TDYs—up to six months
deployment—to GS, or General Schedule, employees.
In future years, the highest demand in Iraq is expected
to be for experienced USAID managers to serve in regional
positions. In Afghanistan, it’s technical officers. Pakistan
needs people with expertise in reconstruction.
Security is a primary worry—and one reason the positions
are so tough to fill. Cohn says that many efforts are made
to keep workers safe while in CPCs, but perhaps the best reassurance
comes from speaking with other staffers who have been deployed
to Iraq and the other countries. “I think it’s really
important to talk to them,” she said, adding they will
be able to talk about their motivations for taking on the
assignments and how they manage their lives in the field.
USAID staff is also required to complete security and antiterrorism
training courses before deploying to Iraq. The area where
staffers work and live is defended at all times by U.S. forces.
In spite of the real concerns about safety, there are some
things that motivate workers to want to work in Iraq and other
CPCs, Cohn said, including patriotism and wanting to make
a difference.
“There is a sense of excitement and interest,”
former Administrator Andrew S. Natsios told USAID/Baghdad
staffers at a recognition ceremony in their honor. “It’s
a history-making event. And people will say many years from
now that you worked on this great project.”
More information and instructions on applying for positions
in CPCs are available online. Employees should go to USAID’s
intranet for detailed information.
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