Try, try again

I have done the opening paragraph one more time.  My biggest challenge is that my organization is humanitarian health aid/health education focused but the funder they want is development focused with an insistence on not providing welfare of any kind.  This project entails both making the rhetorical situation challenging.  I'm shifting my talking points.


I would like to know if I have adequately introduced the context of the problem, the aspect that we intend to address through the current project, the goals, the plan, and the instrumental purpose.

INTER-AMERICAN FOUNDATION

PART 2: NARRATIVE

Families of Shada endured many changes evacuating Port Au Prince after the 2010 earthquake.  Yet, in their new, underdeveloped surroundings south of Cap Hatien many things have stayed the same for disadvantaged women and children, 95% of whom are of African origin.  Women still head households (44% in Haiti) and 62.2 % contribute to the struggling economy through employment and independent work (Committee on the Elimination of Discrimination against Women [CEDAW], 2008).  Beyond the gender discrimination they must struggle to overcome, their contributions to economic development and quality of life are hampered by the same issue that contributes to the highest maternal (350/100,000 live births) and infant (25/1000 live births) mortality rates in the Western Hemisphere. 

Many think of this as a health care system problem; however, to a greater extent it is a lack of community education to equip Haitian women to improve their own health outcomes through the coordination of and informed use of community resources.  MamaBaby Haiti’s (MBH’s) next critical task is to undertake with other grassroots community partners and the Inter-American Foundation (IAF) a pilot education program designed to improve community knowledge of and access strategies for family planning, sexual health, and natal care throughout Shada and 3-7 fishing villages south of Cap Hatien.  This pilot project, which will involve the addition of a mobile clinic to expand the reach of MBH’s established facility, will 1) contribute knowledge to the development of similar service networks in other communities, 2) improve the economic productivity of area women by teaching them how to improve their own maternal and infant health outcomes, and 3) prepare area women through their participation at various levels in the project to lead out in addressing numerous development issues in this region, which has experienced explosive, unmanaged population growth since the 2010 earthquake.

Learning to Identify with the People of Shada by Starting Over

I have rewritten the opening of my narrative trying to incorporate the identified partnership opportunity and connections between the IAF and MBH missions.  To make these connections visible in my blog, I use bold type for words that repeat or reflect concepts in the IAF mission statement and CFP.
In response the IAF's instructions to address community context and the project (that order) in the narrative, I have also tried to maintain an introduction to the context, including relevant characteristics of involved communities, the nature of established connections, and the situations to be addressed.
I am concerned that this paragraph is too long, but that subdividing it (as marked in brackets) would remove the project proposal from the first paragraph and put the urgency on page 2.  I would like feedback about these considerations.
I'm still grieving over the loss of my original paragraph which I thought would help the North American funder understand the significance of a 7-kilometer trip to the hospital.  However, I have been able to incorporate other (probably more) important contextual information with this new approach.
Thanks for your ongoing input.

Families of Shada endured many changes evacuating Port Au Prince after the 2010 earthquake.  Yet, in their new, underdeveloped surroundings south of Cap Hatien many things have stayed the same for disadvantaged women and children, 95% of whom are of African origin.  We still see pregnancy and birth as a normal part of life, not an illness that should send us to a hospital.  Over 60% of our children are born at home (Ministry of Public Health and Population, Haitian Childhood Institute, and ICF International, 2013).  This is our way. [¶] The nurse midwives of Mama Baby Haiti (MBH) Clinic understand these ways and the risk of not detecting the signs that a normal pregnancy or birth is becoming abnormal.  It’s like overlooking the signs of an impending earthquake and waiting until it’s too late to escape.  MBH’s midwifery-model clinic has been working in this newly populated area for over 18 months establishing a culturally-sensitive clinic, gaining the confidence of disadvantaged women, and connecting with area matrones (traditional midwives), as well as the regional hospital, on a mission to improve maternal and infant health outcomes in Haiti, the most dangerous place to give birth in the Western Hemisphere.   Much is left to be done in extending the education of the matrones, new nurse midwives, and childbearing families.  [¶] The next critical task MBH needs to undertake with the Inter-American Foundation (IAF) and other grassroots community partners is a pilot education program designed to improve community knowledge of and access to family planning, sexual health, and natal care throughout Shada and six nearby fishing villages.  Without this partnership, area Haitians will not be equipped to make health-related decisions that are critical to enhancing their joy in childbearing, and we can expect to see another year when 25 newborns per 1,000 live births will die and 350 mothers per 100,000 live births will die.  That is a high price to pay for lack of knowledge.

Working with Forms

I continue to rework information that I have completed on the Inter-American Foundation form which is available as a .docx.  It looks like this:

Filling in the spaces is awkward at times.  I would like some input on how to handle this.

1.       Blank lines are given which move when I type over them.  Should I remove them but underline the information I enter?  Should I remove them and not underline the new content?

2.       Boxes are placed before titles, giving me an opportunity to mark the correct title. I can’t put the mark inside the box.  Do I mark it (as below) before the box?  Remove the box and mark? Or mark with a boxed x of my making?

3.       Should I use 9 pt. type as they do?  It seems very small, and they require 12 pt. double spaced on the narrative.  Should I use bold, making the entries stand out? If so, on everything or just short answers and headings? Should I use a serif font, such as Times New Roman to make the entries obvious?  Should I double space as in the narrative, though their headings in the form are not double spaced?

4.       I’m thinking that I’m expected to fill in their actual form since it is available as a .docx.  If that is not necessary I could create a Word file with all the headings they have, but avoid the busys boxes and unrelated options, such as Mrs. and Ms on a line for a man’s name. I think that might create flags that applicants could leave out items they don’t want to answer, though.

I appreciate input on these issues.  I’m accustomed to more control over the appearance of my document.

Opening the narrative

I’m working on the narrative for my larger grant this week.  I’m establishing the context and preparing to introduce the role of various parties, including the targeted funder, IAF.

My narrative can be ten, double-spaced pages.  I’m trying to decide if I am taking too long in establishing the context.  Should I drop portions such as the first paragraph and the paragraph that ends “Mwen regret sa”?

In the first paragraph, I’m not primarily trying to establish pathos, though I believe that happens.  My primary goal is to clearly portray the transportation challenges of laboring women. 

I appreciate your feedback.

INTER-AMERICAN FOUNDATION

PART 2: NARRATIVE

The motorcycle painfully labors its way through the muddy, predictably washed out streets. The extra passenger’s tears merge with rain in rivulets descending her tired face.  Something’s gone wrong.  She loses count of contractions as they bump their way 45 minutes to Justinien Hospital in Cap-Haïtien.  Any they pass that are stuck in the storm count her lucky for she must have the gourdes for the xxx and xxx required to enter the hospital.  If only there is room and time.

Inter-American Foundation is committed to supporting the self help efforts of Haiti’s disadvantaged and excluded population of women and children, 95% of whom are of African descent[1].  Nowhere else in the Western Hemisphere are women and children more excluded from the basic community services necessary for healthy living conditions.  As a result, Haitians suffer higher infant and maternal mortality rates than any other nation in their hemisphere.  One in 83 Haitian women can expect to die as a result of a pregnancy[2].  The most recent reports show that out of every 100,000 live births, 350 mothers died (2010 data)[3] and 25 vulnerable newborns (2012 data) died[4].  This neonatal mortality rate is 2.5 times higher than the Latin American and Caribbean rate as a whole[5].  The maternal mortality rate is almost four times as high as the regional rate[6].  Those that dwell in cities have better access to medical services, sanitary conditions, and clean water—key factors in improving birth outcomes—making rural [JW1] mothers and infants the most neglected of the most vulnerable in Haiti, the most dangerous place to face birth in the Western Hemisphere.

By the time these rural women wend their way to an overcrowded, understaffed, distant hospital, it is far too likely that they will hear, “Mwen regret sa[7].”

Seven kilometers south of Cap-Haïtien, professionally-trained, local midwives and Santo Choute are working alongside the families of the area to build a stable birth clinic in Morne Rouge where maternal and infant mortality can be reduced through critical education and compassionate care in a clean 24/7 birth center.  In 18 months of operation the clinic has already been established as a trusted and compassionate birthing location with at least one referral coming from the regional hospital.  We have initiated dialogue with a number of other organizations in the area with complementary goals and begun educating families about maternal and infant health issues. 

We are now ready to strengthen these community connections.  There are two prongs to this project.  First, to reach those that lack transportation to the clinic we need a mobile outreach clinic to provide seven surrounding fishing villages with monthly access to pregnancy and sexually transmitted disease tests, basic pregnancy and family planning education, and iron supplements.  The second task is to more formally establish working relationships with the regional hospital and NGOs to better utilize the resources each of us has to contribute to improving the quality of life for this marginalized population.  Together with IAF, we can launch a pilot community education program and services network that can improve the living conditions of this region and transform young women, as they establish their adult identity, into knowledgeable adults that feel capable of managing their own lives and that hold new hope for their communities.

---

[1] (The world factbook 2013-14, 2013)

[2] (World Health Organization, 2012)

[3] (World Health Organization, 2012)

[4] (UN Inter-agency Group for Child Mortality Estimation, 2013)

[5] This is based on data available in Levels and Trends in Child Mortality: Report 2013( (UN Inter-agency Group for Child Mortality Estimation, 2013)

[6] This is based on data available in Trends in Maternal Mortality: 1990 to 2010 (World Health Organization, 2012)

[7] “I’m sorry (your baby died).”

---

 [JW1]48% of the 2010 population lived in rural areas per the CIA Factbook 2013.