Rev. Leslie Hunter: I don’t know about you.

School children: I don’t know about you!

Rev. Hunter: But I’m ready for chapel.

School children: I’m ready for chapel!

JUDY VALENTE, correspondent: It may look like a pep rally, but at Holy Family Ministries they call this chapel—the Wednesday afternoon worship service. Outside these walls is one of the highest crime neighborhoods in Illinois. In here, the students are enthusiastic and well-behaved.

“God is good…”

VALENTE: Holy Family Ministries calls itself a new model for Christian education at a time when faith-based schools, especially those in the inner cities, struggle to stay alive.

DR. MARTIN MARTY: They have always struggled, I think you’d say, but the only time they didn’t is when they were tied to a single congregation, a single parish, where every parent had a child, and they automatically supported it.

VALENTE: As neighborhoods change and congregations shrink, there aren’t enough students, parents, or dollars to support faith-based schools. Susan Work is president of Holy Family Ministries.

SUSAN WORK (President, Holy Family Ministries): These schools are the jewels of their neighborhood, and we need to save them. But we can only save them if we have economic models that are more sustainable than one parish, one school.

VALENTE: Holy Family Ministries dispensed with the traditional model of a church school to pass on doctrine. Instead, it created an umbrella organization that offers a variety of social programs in addition to classroom instruction. The idea isn’t to proselytize, but to instill ethics and values.

VALENTE: Holy Family started in 1985 as a small Lutheran school. It raised $7 million in private funds to build this facility three years ago. Today, Holy Family is a nonprofit social services center and an Episcopal charity, as well as a Christian school.

WORK: We’ve had census workers training in here, we have wedding receptions, we’ve had a lot of baby showers, birthday parties, funeral repasts, just all kinds of things. By having a not-for-profit entity over everything we could access some other sources of funding that we would not otherwise be able to attract if we just stayed as Holy Family Lutheran School, a private school.

VALENTE: Only fifteen percent of Holy Family’s income comes from tuition. It gets the rest from private donors, grants, and government.

Voice on school intercom: “Good morning Holy Family….”

VALENTE: To tap into that broad donor base, Holy Family draws a careful line between its social programs, which receive funding from the government and other secular sources, and its faith-based school, where the day begins with prayer followed by a mission statement.

School children reciting mission statement: We, the students of Holy Family School, faithfully commit ourselves to spiritual growth and Christian values….

WORK: I love the mission statement because parents wrote it. The children pledge to listen to God, accomplish miracles, and be the best that they can be each and every day.

School children: … and to be the best we can be each and every day.

Classroom singing: “There are seven days, there are seven days, there are seven days in the week….”

VALENTE: This is part of Holy Family’s secular outreach: a preschool program funded by the Chicago public schools.

WORK: Chicago Public Schools doesn’t really care where the program is delivered. They’re interest is in seeing that at-risk children all have a preschool experience that will prepare them for later success.

VALENTE: The preschool program has its own director and budget and offers no religious instruction or activities.

WORK: There’s a lot of research out right now about preschool that shows a correlation with later life outcomes. For example, lower rates of incarceration, lower dropout rates for high school, increased entrance into college.

VALENTE: Holy Family’s after-school programs, which emphasize fitness, and its nine-week summer camp are also secular. Both are funded by the government.

WORK: They are subsidies provided to parents to enable them to be out in the workforce. It subsidizes their childcare so that the parents can work.

Student: And now we have to do our multiples…

VALENTE: But from 8 am to 4 pm, Holy Family is a faith-based school for 200 children, kindergarten through eighth grade.

WORK: Teachers do what they’re comfortable with. We don’t impose a certain amount of religious activity in any teacher’s classroom.

VALENTE: Formal religious instruction takes place on Wednesdays.

Teacher: We’ve already talked about the spiritual life and our prayer life…

WORK: Our goal with every child is that they would have a personal relationship with God by the time they leave this school.

VALENTE: But the emphasis is on academics. Holy Family has a 100 percent graduation rate, and in the past five years nearly 90 percent of its students have gone on to either private high schools—with scholarships—or charter schools.

WORK: We want to turn out children of faith, but we know that those kids have to have skills. Otherwise, we’ve turned out wonderful human beings who don’t have a job.

VALENTE: This is what the Wednesday chapel service looks like.

WORK: We’re not putting up any barriers that would keep people of various faiths from joining in the fun. We make faith development a very lively and attractive part of our program here, and we just try and keep it accessible to all the children, no matter what their background is.

VALENTE: For the parents, religion is not the most important thing here. Martin Marty:

MARTY: They simply want the best education for their child. Trust is the big thing. They trust them to affirm the best in the family values. The schools are usually small enough that the teachers get to know everyone.

VALENTE: Tuition is $7200, but the school pays more than half of that and must raise more than a million dollars a year to do it. At events like this it tries to broaden its donor base by touting Holy Family as an investment in the community.

CHERYL COLLINS (Principal, Holy Family School): It’s safe, it’s affordable, it’s faith-based, and Holy Family gets results. It’s not uncommon at 3:00 to hear sirens instead of school bells in our neighborhood, and the sirens are going to these schools because there are gang fights and gang activity that take place.

Malik: My name is Malik and I’m in fourth grade.

VALENTE: To reach more affluent people Holy Family put its development office 30 miles away in the prosperous suburbs of Chicago’s North Shore. Half its income comes from donors, and that includes more than thirty congregations in the Chicago area.

Malik: Teachers and tutors help us, and then we can make better grades. I know, because I have been on the honor roll many times.

VALENTE: Michael Berkowitz is a business leader who caught the Holy Family spirit.

MICHAEL BERKOWITZ: It’s not about the faith ofwhat I believe in or what the students believe in. It’s the fact of the goodness that’s being done here. It has nothing to do with the religion, as far as why I would contribute my time and money. It has to do with how well they are treating students.

VALENTE: Martin Marty thinks other faith-based schools, including those that are Catholic, would do well to emulate Holy Family’s approach.

MARTY: I think the model of the faith-based schools would be an excellent model for Catholicism. They are just seeing their parochial schools die by the hundreds across the nation every year. I’ve been spending enough of my life on campuses to know how conservative, structurally, educational institutions are. If we’ve always done it that way, it’s awfully hard to think of the new.

Singing at service: “Lean on me…”

WORK: Sure, we’re one school, but we’re turning out leaders for the community for tomorrow. We’re turning out the kids who are going to be able to finish college—not just get in, but finish—and have good careers.

Singing: “Lift every voice…”

WORK: Also, I think we’re affecting the community in a less measurable way by the symbol of hope and optimism that we have brought into this neighborhood.

VALENTE: Supporters of Holy Family believe that as long as it can keep the lights on and the books open it can transform this part of the city—one child at a time.

For Religion & Ethics NewsWeekly I’m Judy Valente in Chicago.

KRISTIN CORNWELL (Teacher, Hanley Elementary School, speaking to students): All right, I am going to give you five seconds to be settled.

BOB FAW, correspondent: In Memphis public schools, where only a small  percentage of students go on to college, Kristin Cornwell tells all her fourth graders they can be “college-ready.”

CORNWELL: The expectations haven’t been set before necessarily even that high, and they live up to it. One of the biggest delights is when I hear kids sitting in their groups, and they’ll whisper to each other, “Get college-ready,” and they’ll sit up straight, and they know exactly what that looks like, and they want that for themselves.

FAW: In a public school system where failure is common…

ERIN SVOBODA (Teacher, Kingsbury Middle School, speaking to students): Where’s the right angle in that diagram?

FAW: …Erin Svoboda’s goal is that 100 percent of her students pass the state math exam.

SVOBODA : A lot of my students are a little bit jaded, and they maybe feel a little bit even cheated. They understand that maybe they haven’t received the education that they should have. So I hope to maybe renewing their faith in their education and the schools and in what they can do with that later.

FAW: In this poor neighborhood, where reading scores are abysmally low, Katelyn Woodard praises her students for trying to find the right answer.

KATELYN WOODARD (Teacher, Hanley Elementary School, speaking to students): It’s by itself beautiful. Good job, Demetria.

Students: Good job, Demetria!

FAW: Katelyn, Erin, and Kristin are graduates of MTR—Memphis Teacher Residency, a  three-year-old program designed to give poor inner city students the same opportunities as students in wealthier areas. David Montague is the director of the school.

DAVID MONTAGUE (Memphis Teacher Residency): It’s absolutely an injustice, because there’s such a large academic achievement gap between students that are generally poor and minority relative to students who generally live in the suburbs and who are white.

FAW: Funded mostly by foundations and private contributions, this program takes college graduates and gives them housing, training, and tuition, even awards them a master’s degree. In return, they agree to teach in an inner city school here for four years. The program is faith-based.

MONTAGUE: What we’re doing here we’re doing within a Christian context. We believe in God’s word as revealed in Scripture, and that faith informs how you think about students. It informs your efficacy. It informs your belief that every child can learn.

FAW: There is something about this work that draws people of faith. Erin, for example, planned a career as a hospital pharmacist until her faith made her decide otherwise.

SVOBODA: I feel like this is absolutely where God wants me to be. I had much different ambitions for my life and much different aspirations. But I feel like the Lord kept putting this in my path.

(speaking to students): Remember what this page is called? What’s this page called?

FAW: Katelyn also sees what she is doing in the classroom as a kind of ministry.

WOODARD: How I want to live out my faith in the classroom is by constantly looking at the Lord and looking at how he deals with the world and reflect that in my classroom. If I treat them with that respect and that love that I really believe the Lord has for everyone, then they feel that.

FAW: Is there any such thing as an unteachable child?

SVOBODA. No.

FAW: To these teachers their students are not potential dropouts, but God’s creatures.

CORNWELL: I’ve seen kids who everyone said, “There’s no way. There’s no way that child is going to be successful.” And I’ve seen them overcome that when someone believes in them, when someone takes the time to sit with them and work with them and pull the assets that we can see from them, and they start to believe, “I can do this.”

MONTAGUE: What we still have particularly in urban education is what some people often call soft racism or soft bigotry, which is this idea of teachers at times having very low expectations of their students because of the race or class that they come from. So what we’re trying to do is say absolutely every single child can learn, and we’re going to have very, very high expectations for those children.

FAW: In this school, presided over by principal Rosalind Davis, the teachers from MTR have already had a huge impact.

ROSALIND DAVIS (Principal, Hanley Elementary School): They’ve changed the culture of the school. Their approach to the work, their work ethic, and their strategies, the way they interact with the students.

FAW: Because, says Davis, these teachers with strong faith bring something many other teachers often lack.

DAVIS: Sometimes what’s missing from a teacher’s belief system is a belief that something supernatural and miraculous could happen in schools. They might get knocked down one day, but they come back fighting the next because they prayed about it, they reflected and, you know, they get up.

FAW: Don’t be misled. The MTR program is not some roundabout way to impose doctrine, much less to proselytize, as Montague explains.

MONTAGUE: If you do a Bible study, and you explain why Jesus is the son of God and the only way to heaven, what you’re doing is you’re creating a very unhealthy and non-safe environment for every child in that classroom that doesn’t come from a Christian family, okay, and so you’re inhibiting your children, your students from being able to learn.

SVOBODA: I might not be able to necessarily tell them that I believe that they’re God’s children and that he loves them, but I’m trying to show that love to them.

DAVIS: Your faith isn’t something that you walk around beating people on the head with. People should be able to tell that you’re a Christian without you saying a word.

FAW: It is grindingly difficult work. Children coming here test well below students in more affluent areas. What is accomplished in the classroom is often offset by what they experience outside. Dealing with all that is a real test of faith.

(speaking to Erin Svoboda): You’re swimming upstream.

SVOBODA: That’s what it feels like most days, yes.

FAW: Your faith keeps you going?

SVOBODA: Yes. I will be honest. I don’t know how other people do it. Without that or motivating you have no ideal how anyone would willingly wake up and come to this every day. I don’t mean to make it sound that terrible, but it is hard.

FAW: The program is so new it is hard to measure its success. But test scores are climbing, and students are responding.

(speaking to student): She pushes you?

TEAVIKA JOHNSON: Yes.

FAW: You don’t mind the discipline? You like it?

JOHNSON: No, because it helps me more so I can understand more.

FAW: (speaking to student): The goal up there says 100 percent. So she really inspires you?

WENDY CABAERA: Yes. Actually, for me she is one of our best teachers.

FAW: And if the cynic were to argue that here they can make only the smallest of inroads, that progress will be scant and short-lived; that goals like Erin’s 100 percent target are not likely to be reached—if so, their faith, they insist, will not be diminished.

CORNWELL: I walk here in knowing that I come with my five loaves and two fish, my meager here’s my best that I have, and God’s going to have to multiply that. Whether he chooses to do that now or 20 years from now in urban education, that’s up to him.

WOODARD: What you come to learn through doing this job and through your faith is that there’s a deeper joy and peace and contentment than you could ever imagine that comes from knowing that you’re doing God’s work.

FAW: As they answer a calling and live their faith one student, one classroom at a time.

For Religion & Ethics NewsWeekly, this is Bob Faw in Memphis, Tennessee.

DR. BRENDA WILLIAMS: (singing) God is a good God, yes he is. God is a good God, yes he is. One more time.

LUCKY SEVERSON, correspondent: This is the medium security pod at the detention center in Sumter, South Carolina, and this is Dr. Brenda Williams, all four feet, eleven inches of her.

DR. BRENDA: OK, now listen up. What were going to do is this. A couple of things, then we’re gonna go on, ’cause I am a very short-winded person.

SEVERSON: She says she was afraid to talk in public until the teacher made her give an oral report in 7th grade. Her husband, Dr. Joe Williams, says that was just the beginning.

DR. JOE WILLIAMS: She was talking when I first saw her and she’s continued to talk since then.

DR. BRENDA: (To inmates) Talk, talk, talk, talk, talk, talk, talk. That’s all some folks do. We do more than talk. We back up our talk.

I called Mr. Mathews and said, “Hi, my name is Brenda Williams,” blah, blah, blah, and he said, “I know about you. You don’t have to give me an introduction.”

SEVERSON: Few in Sumter would deny that Dr. Brenda Williams is a force of nature, or that her husband Dr. Joe is the calm in the eye of the storm. She’s a general practitioner. He’s an internist and geriatrician. They’ve run a clinic in this city of 100,000 for 30 years. No one is turned away. Her latest project is called Do Right and the folks who agree to “do right” get on the list to get a free home. So far they’ve given away four.

PATRICIA DUNHAM: This is my dining room. I never had one of those before.

SEVERSON: (to Patricia Dunham) It’s a nice dining room.

It’s the first house Patricia Dunham has ever owned. For her and her husband and three kids, it’s a dream come true. It may be comfortable now but it wasn’t when the doctor found it.

DR. BRENDA: The house had a porch that was falling in. It had 59 broken window panes. All of the wiring was stripped of copper. The plumbing stuff was missing.

The houses are not just given, quote unquote, “given” to the families, they have to work for it. They have to earn it.

PATRICIA DUNHAM: I do community service, clean up paper, go to church, be active in my kid’s schooling, come to the meetings once a month, basically easy stuff that’s not hard to do to get a free home, and I thank you very much. (hugs her)

SEVERSON: The cost of fixing-up these fixer-uppers comes out of the Williams pockets. They receive no outside funding. But they’re not pushovers. People who don’t follow the rules don’t get a home.

DR. BRENDA: The Do Right families have to do at least 4 hours of community service a week. The Do Right families have to turn in a church program. The pastor or the leader of the religious organization has to sign that program and date it. I want a written report, not an oral report, it has to be in writing…

SEVERSON: You’re pretty tough.

DR. BRENDA: Yes, I know.

SEVERSON: Nick McCormac is a staff writer for Sumter’s newspaper The Item. He’s covered Dr. Williams.

NICK MCCORMAC (The Sumter Item): She doesn’t want people to take things for granted, basically. She wants them to earn it. It’s to give them that empowerment, to make them proud of themselves, to build themselves up so they can go on and own their house or be a voter and be engaged and have that pride that comes along with those kind of things.

DR. BRENDA: It’s demanded that the recipients of that free home go back to school and get a high school diploma if they haven’t graduated from high school. It’s mandatory.

SEVERSON: Patricia got her high school diploma. Now she’s attending college, and she has her own home.

PATRICIA: It feels so good when I go pay my taxes in January.

SEVERSON: Linda Prince earned her new home by following the rules, which includes cleaning up litter in the neighborhood.

DR. BRENDA: The neighborhood is improving and you know one thing, we ran the drug dealers away. OK, there might still be one or two hanging around somewhere, but there was a house not too far from here, by the way, that was all the time frequented by drug dealers, and they’re gone now.

DR. JOE WILLIAMS: I for one believe that this is the best country in the world. I believe that we all have to figure out a way to make it better.

SEVERSON: It’s a calling for them, making things better, a way to pay back for their good fortune. Both are deeply religious. He is a United Methodist. She belongs to an Apostolic church.

DR. BRENDA: (singing) And we all know that he loves us.

SEVERSON: She says she gets her inspiration from the good book, from scriptures like the 41st Psalm, verse one.

DR. BRENDA: “Blessed are ye who consider the poor for the Lord will deliver you in your days of trouble.”

DR. JOE: There’s a large portion of our community, the so-called underclass, that seem to be mired I poverty. And really, as I tell my wife all the time, those are the people I’m really concerned about.

SEVERSON: For them, the core of the problem facing the African-American community is the break up of the family.

DR. JOE: We have problems with men and women not getting together and getting married, or breaking apart in terms of the family, that we really feel very discouraged about.

SEVERSON: Makesha Kennedy is an exception. She and her husband were married ten years ago after the Williams prodded them and other couples to tie the knot.

Makesha has three children, getting good grades, with a father at home. She now works at the doctor’s office. So does Amanda Elizabeth Wolf. She met Dr. Brenda, as the staff calls her, when she was in jail a year ago.

AMANDA ELIZABETH WOLF: I mean, we’ve come a long ways, and you know, I have to give number one credit to God, but if it weren’t for Dr. Brenda and Dr. Joe, I wouldn’t be blessed with this house right now.

SEVERSON: Amanda is now a member of what is known as the Do Right Crew, mostly former inmates who meet with the Do Right Kids, youngsters Dr. Brenda has recruited, to do community service and talk about the problems of growing up.

AMANDA ELIZABETH WOLF: You know whenever I do, I guess, want to relapse or think about going back to my old ways, I think, you know, well I’m accountability to the Do Right kids, you know. And I don’t want to have to go to them and say, “Hey, listen, I screwed up, I’m back in jail.”

DR. BRENDA: I need you to sign up. Here’s lime-green paper, it says do right, do right, do right. If you’re part of the Do Right Crew, there’s so many benefits that come along with being part of the Do Right Crew.

SEVERSON: Even these prisoners are eligible for a free home, and she’ll help with a job too, if they “do right.”

DR. BRENDA: I’ll do everything I can to find you a job. I can’t promise you that job will come but I’ll sure do my doggone best to help you get a job.

SEVERSON: The director of the detention center says he had to turn the lights out late one night to get her to go home, but he’s glad she comes.

SIMON MAJOR (Sumter Lee Detention Center): She’s very encouraging, but not only that now, there’s another population that she talks to also, as she speaks with the inmates, our officers get to hear that same encouraging word.

SEVERSON: And then she gets to her most passionate cause right now, registering pre-trial inmates to vote.

DR. BRENDA: Your vote is just as powerful as Donald Trump’s vote. Your vote is just as powerful as President Barack Obama’s vote. Your vote is just as powerful as Oprah Winfrey’s vote. Your vote is just as powerful as Bill Gate’s vote. They’re billionaires. You have power.

SEVERSON: Before she was done, most of the men signed up to register to vote. It’s not an easy process in South Carolina.

DR. BRENDA: (To inmate) I’ll bet your momma has your birth certificate.

(To inmates) You all come and give us a hug, we love you now..

The bible says that many are called but few are chosen. But I truly believe that he chooses certain individuals to do his tough stuff.

(singing) Thank you Jesus.

SEVERSON: For Religion & Ethics NewsWeekly, I’m Lucky Severson at the Sumter Lee Regional Detention Center in South Carolina.

FRED DE SAM LAZARO, Correspondent: Among emerging nations, Brazil is a leading power. It’s booming economy is now the world’s seventh largest. Yet this nation of 200 million remains very divided. Its poverty is on display along the hillsides, not far from Rio de Janeiro’s glittering skyline, or along the sidewalks of Sao Paolo, despite recent government attempts to address it.

MARIVALDO DA SILVA SANTOS: There’s still great inequality in Brazil. There still are people who don’t have a place to sleep, don’t have clothes, any happiness in their lives.

DE SAM LAZARO: Santos works for a Catholic social services agency in Sao Paolo called Bom Parto. Brazil’s government has increased the minimum wage and created a social safety net, and it’s relied on several faith-based groups like Bom Parto in its anti-poverty efforts.

About 70 percent of Brazilians are Catholic. Church attendance has dropped sharply in recent decades, except in newer Protestant evangelical congregations. But the demand for church-run social services has not dropped.

Bom Parto, short in Portuguese for “our lady of good delivery,” is the biggest such provider in Brazil. It’s headed by Sister Judith Lupo.

She grew up in a wealthy family, was educated in Brazil, the U.S. and France after joining her religious order, where she soon became its chief finance officer.

At Bom Parto, she combined government contracts with private philanthropy and built a single day care center three decades ago into an organization with 58 locations and 1100 employees, serving 10,000 people each day. It’s all pulled together with a modest $4.5 million annual budget—reflecting financial acumen; also a simple philosophy.

SISTER JUDITH LUPO: I think the first, first thing is to love people. They need money also to survive, but it’s not just to get money or to learn things, it’s to learn in a way that it’s with love.

DE SAM LAZARO: As an example of the approach, she says this homeless shelter provides much more than a roof and a meal for its 600-odd clients. There are baths, clinics and career counseling among other services—even entertainment, like this traditional dance called capoeira.

DA SILVA SANTOS: Bom Parto has given me continuity. It took me to college, it helped me understand public policies not only to help myself but others. It offers not just food and bathing services, it teaches about need to work, instruction, training, pleasure, culture. It enables you in a way.

DE SAM LAZARO: Thirty-six year old Santos is a poster child. He came here in 2002, an alcoholic down on his luck. His life is more than restored, he says. Bom Parto employs him and is also helping with part of the tuition to complete his degree in social work.

DA SILVA SANTOS: Sister Judith insists that people on her staff come out of places like this. She has this poem called “I Am You.” She’s put herself in our position, feeling our pain, feeling our situation. That’s how she’s able to help us and that’s the same thing she is getting us to do.

SISTER LUPO: I feel the young people and children, adolescents, all of them, they all need an opportunity. It’s, I don’t think poverty has to take them out of a normal life. They should not live always in a bad house. They should not be always in a favela. And to go out of those places, they need a good education.

DE SAM LAZARO: Poverty is endemic in Brazil despite its bountiful natural resources and a modern economy. Sister Judith blames much of it on an unequal education system that traces back to slavery, which was abolished in 1888.

Bom Parto serves a wide range of needs, caring for abandoned HIV-infected infants. Also destitute elderly. However the major focus is on education and training to enter the prosperous mainstream of Brazil’s economy.

On the outskirts of Sao Paolo, where many of the city’s poor reside, Bom Parto’s day care facility is at its capacity. It cares for 3,300 preschoolers across the city. Eventually, many of them will enter this school…

SISTER ADRIANNA APARACIDA ROMAO: Here in this place, we serve about 1,100 kids. And given our waiting list, we should have at least three spaces this big in order to serve all of our community.

DE SAM LAZARO: Public education is widely perceived as substandard in Brazil, and that accounts for the strong demand for schools like this one, run by Bom Parto.

SISTER ADRIANNA: In the 27 years that this school has been here, we’ve seen great change, improvement in the community and in the lives of these children. The evidence is when we’re watching them during recess. They’re calmly interacting with their friends, not supervised, not gated in like the public schools, where they’re still very unruly. Here they’ve learned to behave.

DE SAM LAZARO: Older students receive vocational training. Most are placed in good jobs and the school sends promising students into a college prep program. A few miles way, a Bom Parto-run program trains auto mechanics and machinists.

LEANDRO AGUSTO DA SILVA, Shop Teacher: Traditionally this eastern edge of Sao Paolo has been excluded, marginalized. The general view is that people who come from here are not going to be able to climb the economic ladder. But we provide opportunities to the kids who are leaving here that differentiates them from the rest of the population in this area. We’ve already had several examples of students from this program that have graduated and gone on to work in the elite areas, other areas of the city.

DE SAM LAZARO: Some graduates have returned as teachers and mentors.

SUELEN RIBEIRO DE CAMARGO, Teacher: In terms of vehicle repair, maintenance, et cetera, I’ve always been interested. In terms of being a teacher, I thought maybe but my sister really pushed me to consider this. I didn’t think it would happen so soon after finishing this program. I was able to get several different apprenticeships and while doing that, this job opening came and I was invited to come back and teach here, and my whole family told me to jump at it. It was an honor for the whole family.

DE SAM LAZARO: About 25% of students here are female, keeping with a trend in which women—from the country’s president on down—are in jobs historically held by men.

SISTER LUPO: If you can cook well, you can repair car well.

DE SAM LAZARO: If you can cook well you can repair a car well?

SISTER LUPO: If you learn, why not?

DE SAM LAZARO: Asked about her own outlook, 68 year old sister Judith Lupo offered few words. They come from the scripture, she says.

SISTER LUPO: It’s from the gospel. We have to give opportunity to everybody. Everybody was created to have life and to have life in fullness.

DE SAM LAZARO: For Religion and Ethics NewsWeekly, this is Fred de Sam Lazaro, in Sao Paolo.

FRED DE SAM LAZARO, guest host: We have the story of an organization founded after federal agents raided the nation’s largest kosher meat-packaging plant in Postville, Iowa, and discovered widespread mistreatment of workers. The group, Uri L’Tzedek, which means “awakened to justice,” wants more transparency in the kosher industry, and they’ve started with restaurants.

RABBI SHMULY YANKLOWITZ (Founder & President, Uri L’Tzedek): What became clear to me in Postville was that we had to take responsibility. Not a one time act like a boycott, but something systemic and sustainable that would ensure that there was ethical transparency in the industry.

RABBI ARI WEISS (Director, Uri L’Tzedek): The Tav HaYosher, which we translate as an “ethical seal” for kosher restaurants, is an initiative that we launched in May 2009. We don’t charge anything for this seal. We have a licensing agreement which they sign. The criteria for our certification is, first and foremost, we want to make sure that people get at least minimum wage, and we want to make sure that overtime based on that minimum wage is given. Then we also want to make sure that people are respected, and work is dignified.

YANKLOWITZ: When we started the Tav HaYosher we said, let’s strive for the ideals. We want health care, we want animal treatment, we want environmental standards, we want fair trade, we want workers comp, all these issues, and we went into restaurants finding workers getting paid $2 an hour, $3 an hour. Ridiculous! So we said we have to first just meet law.

WEISS: One of the really exciting things about this program is that it’s a grassroots program. The people who actually go into the restaurants are volunteers, college students, graduate students, young professionals who care deeply about this mission and about this project. Every two or three months or so we have a training, and then we actually assign restaurants to each of the compliance officers.

YANKLOWITZ: There is nothing easy about the work we’re trying to engage in. We are sending young volunteers to ask owners to open their books, to speak with workers about very sensitive issues.

WEISS: We take them aside so that we create a safe space away from management, and we ask them questions to verify what the payroll actually says. How many hours have you worked? What is your pay? What’s it like to work here? Do you feel ever harassed? The feedback we receive from restaurant workers, we keep it anonymous, and we also have an anonymous tip line.

SHLOMIT COHEN (Tav HaYosher Compliance Officer): We’ve approached locations that initially didn’t meet standards. We spoke with them, encouraged them and were able to come back and actually sign them on.

YANKLOWITZ: Sitting in a dark basement with a worker who paints black and white cookies black, white, black, white all day, every day and seeing his eyes tear up when for the first time there was a customer concerned for his welfare, that rocked me spiritually, emotionally to feel the impact of merely showing somebody else that we’re present for them. We’re an advocate for them.

WEISS: We see this very much as a partnership between workers, the community, and restaurant owners.

NOAM SOKOLOW (Owner, Noah’s Ark/Shelly’s): I think I just felt as a good person, someone who believes in doing the right thing. I think it was important to set the standard. We’ve actually gotten numerous phone calls and numerous comments from customers who have come in and let us know that they are supporting us because of the fact that we have the seal.

YANKLOWITZ: This is a new wave of activism, an activism through what one eats, that what we eat and what we buy is a vote of confidence in our highest values.

DE SAM LAZARO: Tav HaYosher has certified over 90 eating establishments in 13 states and Canada.

KIM LAWTON, correspondent: The famine in East Africa continues to worsen with humanitarian officials now saying that more than 12 million people are in need of emergency food assistance. The United States this week announced an additional $117 million of aid for the region and urged other nations to follow suit. More than 400,000 Somali refugees have flooded into camps in Ethiopia and Kenya seeking help. This week, former US Ambassador to the UN World Food Program Tony Hall was in Kenya visiting one of the largest refugee camps. I spoke with him there via Skype.

Well, Ambassador Hall, tell us about the conditions that you’ve being seeing on the ground there.

AMBASSADOR TONY HALL (Former US Ambassador to the UN World Food Program and Executive Director, Alliance to End Hunger): Well, the situation on the ground, it’s bad and it’s not getting any better. I think that the sheer volume of people that are coming over the border, it’s overwhelming. I must say that the UN and the NGOs that are working on the ground are doing a great job. I think the people that are donating money, I think they, you know, they ought to feel good about the fact that their money is getting through. These programs are working. People are being served. But the volume of people, I mean, and the volume of the problem is amazing. Twenty-nine thousand children have died in the last 90 days. Four-hundred thousand people have been fleeing from Somalia because of the tremendous amount of violence and coupled with the drought—these people have not only been fleeing because of violence, they’ve been fleeing because they’ve lost their livelihood.

LAWTON: What are the biggest challenges the aid groups face right now?

HALL: I think the biggest challenge probably is the sheer volume of people that are coming. Fifteen-hundred people are coming over the border every day. I mean, they’re walking for, you know, a month-and-a-half to two months. I mean, can you imagine? I mean, I can’t imagine this, but they’re walking basically with whatever they can carry over a desert. In some cases they’re walking a hundred to two hundred miles, and they’re fleeing a very violent terrorist group. They have to also be very careful about, you know, these gangs, and they’re out there, thugs that are out there robbing them of whatever they have. The women are very susceptible to being raped along the way. They arrive, and when you see them, I mean, they are exhausted. Many of their children are malnourished, but, you know, they have this tremendous gift of wanting to survive, and, you know, when they get here you see a little bit of hope in their eyes even though they’re exhausted and thin and malnourished, and they think, well, they’ve arrived, and there’s a little bit of hope here, because there’s water and there’s food and there’s a place for them to stay, and that’s pretty neat.

LAWTON: How can you make the case for more aid, more donations coming in in the face of this global economic crisis we’re seeing here in the US, the stock market, and around the world? How can you make the case for people to give?

HALL: Our country has always been generous. Our country is a country that is known for its humanitarian aid, its development assistance, not only in our own country but overseas. That’s what we’re known for, and I think for us to reach out and to, you know, to help the least of these is—it shows moral authority, and it shows what we’re all about.

LAWTON: Ambassador Tony Hall, thank you very much.

KIM LAWTON, correspondent: It’s graduation time at the Helping Up Mission, a nondenominational Christian ministry for poor and homeless men in Baltimore. On this day, several men are being recognized for reaching new stages of success in their recovery from drug and alcohol addiction. Helping Up believes that spirituality plays a key role in the recovery process, and it wants those who work there to reflect its values. The ministry relies largely on private donations, but it has received some public funding as well, and that raises a difficult question: If the mission takes government money, should it still be allowed to only hire people who share its religious beliefs?

BOB GEHMAN (Executive Director, Helping Up Mission): A faith-based organization is only faith-based if it can hire people of the particular faith that it espouses, so if, for instance, we were not able to discriminate in our hiring practices based on our faith and religion, that would change us.

BARRY LYNN (Executive Director, Americans United for Separation of Church and State): I don’t think that there’s any moral or ethical or constitutional justification for a religious group taking government funds, tax dollars, and saying we’re only going to hire the people we want, we’re going to have a religious litmus test for hiring. That’s dead wrong, and it should be stopped.

LAWTON: For decades, religious groups have been partnering with the government to provide a host of social services in the US and around the world. Those partnerships attracted new visibility—and new controversy—after President George W. Bush created his faith-based initiative—

PRESIDENT GEORGE W. BUSH: People who don’t have hope can find hope.

LAWTON: —in his words “to level the playing field” so that more religious groups could compete for government grants.

A series of laws, regulations and court decisions have tried to ensure that the faith-based partnerships don’t violate the Constitution. For example, tax dollars may not be used to fund proselytizing. But the issue of religious hiring remains one of the most contentious questions. The Civil Rights Act of 1964 and its regulations banned discrimination in hiring but granted faith groups an exemption, allowing them to hire on the basis of religion. But Barry Lynn, executive director of Americans United for Separation of Church and State, says federal funding should change the calculus.

LYNN: Whenever government money enters the picture, then the civil rights rubric of our country is you don’t get to discriminate anymore. If you’re engaged in federal work with federal money, you really have to play by the same rules as everyone else. You don’t get to be a bigot, you don’t get to discriminate, you don’t get to select people for a job or fire people from a job because of their religious beliefs or orientation.

LAWTON: Stanley Carlson-Thies heads the Institutional Religious Freedom Alliance, which helps faith-based groups protect their identity and practices. He says the law allows religious groups to create an organizational philosophy as other federally funded entities do.

STANLEY CARLSON-THIES (Executive Director, Institutional Religious Freedom Alliance): I think the faith groups see it as, you know, like a Democratic senator hires Democrats for his or her office, and environmental groups hire environmentally sensitive people, and so on, and they say hey, we’re a faith group, it’s faith that motivates us, defines us, so we’re looking for people who are, share that faith.

LAWTON: Carlson-Thies sees this as an issue that pits an individual’s rights against institutional rights. He says for faith groups it’s not discrimination in the traditional sense.

CARLSON-THIES: It’s not that they think of this as you grew up on the wrong side of the tracks, we’re going to keep you out. No, it’s more do you share the things that motivate us? Do you have the same set of values? Do you have the same set of behaviors?

LAWTON: On the presidential campaign trail in July 2008, candidate Barack Obama visited a Christian youth program in Zanesville, Ohio, and promised that his administration would continue partnerships between faith-based groups and the government. But he said there would be a few caveats.

PRESIDENT BARACK OBAMA: First, if you get a federal grant you don’t use that grant money to proselytize to the people you help, and you can’t discriminate against them, or against the people you hire, on the basis of their religion.

LAWTON: When President Obama set up his White House Office of Faith-Based and Neighborhood Partnerships, many civil rights groups expected to see all religious hiring preferences banned in federally funded programs. That hasn’t happened. Instead, Joshua DuBois, head of Obama’s faith office, has outlined a different course.

JOSHUA DUBOIS (White House Office of Faith-Based and Neighborhood Partnerships, in speech): With regard to the issue of co-religionist hiring, hiring discrimination hiring, it’s a difficult topic and one that where there are very clear and strong opinions on both sides. The president has decided to take a case-by-case approach, and as difficult legal issues arise he wants me to work with the White House counsel, with the attorney general, to explore those issues and give him a recommendation.

LYNN: A case-by-case basis is like saying, well, maybe Rosa Parks may be in the front of the bus; other African-American women, they get into the back of the bus. There is no way to deal with fundamental civil rights issues on a case-by-case basis.

LAWTON: Both Carlson-Thies and Lynn were on a task force about government partnerships for Obama’s Faith Advisory Council. But the hiring question wasn’t allowed to even be part of the discussion. It’s an issue of deep concern for many faith-based charities, including Helping Up in Baltimore. The residential addiction recovery program has about 400 homeless addicts who live here for at least a year. They go through a 12-step program and receive counseling, medical help, job training, and Bible study. Executive director Bob Gehman says faith is crucial in the program’s effectiveness.

GEHMAN: Many of our men here have tried other programs, and they’ve come to us because they particularly like the faith-based ingredient that we have here. It offers them the kind of hope that they need in order to get beyond all the failures that they’ve had in the past.

LAWTON: That was the case for Michael Anthony Gross, who came here after three decades of cocaine and heroin addiction.

MICHAEL ANTHONY GROSS (Helping Up Mission): When I was in detox, I talked to a gentleman, and he recommended the Helping Up Mission, and he spoke about the spiritual basis that, you know, the program is run on, and I come to know that after all these years that’s what I was missing.

LAWTON: The mission’s internal surveys have found that two years out, almost 80 percent of the men who complete the program are still drug-free and employed. The program accepts men from all religious backgrounds, and leaders say religion isn’t imposed on anyone. The men may opt out of chapel or Bible study, but if they do they must attend another 12-step-style meeting. Tom Bond is Helping Up’s program director, who in 2002 came here himself as a homeless addict.

TOM BOND (Helping Up Mission): The whole faith and recovery both are highly unique. What we do is we just try to kind of create a platform and a vehicle for these guys to succeed and make things available to them and let them figure things out for themselves, not force it on them.

LAWTON: Gehman says the mission has been careful not to use any public money for the explicitly religious parts of the program. But he says hiring people who share the mission’s faith is central to maintaining its identity. If the government makes nondiscrimination a condition, they wouldn’t be able to accept public funding, and he says that would give other groups an unfair advantage.

GEHMAN: It really gives secular organizations a real power-edge, because they’re fully funded. They can build their buildings, they can develop their programs, and the faith-based organizations are left to have to raise their own money, which is becoming increasingly difficult.

LAWTON: Indeed, says Carlson-Thies, if the administration changed the longstanding policy, many charities from across the religious spectrum may be forced to end their partnerships with the government.

CARLSON-THIES: It’s not that we just say, well fine, if you want to walk away, walk away, because this implicates billions of dollars and a big volume of services.

LAWTON: One organization that might be affected is World Vision, the largest US-based relief and development group. World Vision has been taking federal funds since 1983 and last year received more than $300 million in cash and goods from the government. The Christian group wants to maintain the right to consider religion in its hiring. World Vision’s chief legal officer told me his organization has never discriminated among its recipients or engaged in illegal hiring practices. But, he said, if the policy changes and World Vision can no longer partner with the government, “the losers would be children in need around the world and American taxpayers.”

LYNN: Scientific studies certainly don’t prove that World Vision is the only group that can help the poor around the world, nor does it suggest that the best charities at home are those that have a religious title affixed to their name.

LAWTON: Under strong pressure from both sides, the Obama administration has been reluctant to clarify its position or make any changes, and White House officials declined to comment for this story as well. But with several court cases moving in the pipelines, the issue isn’t going away.

I’m Kim Lawton in Washington.

BOB FAW, correspondent: Question: What do this longtime alcoholic, this up and coming project manager, this receptionist who was homeless, and Noah Haynes, who just turned one, have in common? Answer: The chance at a better life because of this former corporate high-flyer and mother of four.

NANCY MURRAY (Builders of Hope): We’re building houses. We’re rescuing houses that are slated for demolition, rebuilding them and making them available and affordable to families who otherwise would be living in pretty substandard conditions.

FAW: For the past five years, her program, Builders of Hope, has found houses about to be demolished and put in a landfill.

MURRAY: So far, to date Builders of Hope has rescued eleven million pounds of debris from the landfill. The only inventory that we work with is inventory slated for demolition. I’d say 99 percent of the homes that are donated that are older have hardwood floors in them. We’re able to restore those. The roofs, the rafter systems, the floor systems—all in really great shape and very usable.

FAW: Nancy Murray’s nonprofit group rescues houses from commercial, road and hospital expansion as well as private donors who want to build larger homes. The houses are rebuilt and refurbished into energy-efficient green houses, as Josh Thompson learned when he moved into his Builders of Hope home.

JOSH THOMPSON: All the paints that they use are all low-chemical and designed to kind of produce a healthy environment.

FAW: Now that’s what we see. What we don’t see—tell me about the insulation.

THOMPSON: Yeah. What you don’t see is spray-on foam insulation across the whole house—amazing energy efficiency with that. You got all these windows are the double-paned.

FAW: In Raleigh, Durham, Charlotte, and other North Carolina cities, Nancy Murray’s Builders of Hope, with help from private and government funds, has restored nearly 100 houses, selling them at an average cost of $135,000. Putting them on land she has bought or that has been donated, Murray sells them at cost to low- and moderate-income wage-earners she calls the working poor.

MURRAY: You say affordable housing and everybody thinks, “Oh, those people.” Well, those people are your teachers, your firefighters, your police officers, your nurse. It’s 70 percent of the working population of any major city, and those are the people who need affordable housing.

FAW: People like Noah’s parents, Dana and Robbie Haynes.

ROBBIE HAYNES: There’s houses like this in the downtown area, but it’s just not with our price range. We couldn’t afford to have those upgrades and different things.

FAW: New home owners like receptionist Nikki McKinnon who also could not afford to buy much of anything on her $25,000 a year salary.

NIKKI MCKINNON: Just having your own—it’s nothing like it. It gives you just a sense of pride and worth. It’s just wonderful just to say that I actually own a piece of land in this world, you know. It’s nice.

FAW: Nancy Murray gave up her job as a marketing and advertising executive to start Builders of Hope with money she inherited from her father and with the knowledge of one of his businesses—construction.

MURRAY: We were building million-dollar vacation town homes, and we were displacing people when we bought property that were renting. We would tear them down and build something else, and I thought, wow, what we’re doing is wrong. You know, I started getting a conscience, like this is terrible.

FAW: So she traded in her stilettos for steel-tipped boots, even bought her own earth-mover. It is, she says, a kind of ministry.

MURRAY: There’s a verse in Matthew that states that you shouldn’t store your money up, you know, where moths and rust and decay set in, but to take that money and invest it in Kingdom work and to really be able to use it to make a difference in loving others and caring for others while we’re here on earth.

FAW: With a staff of 60, her Builders of Hope scours a 60-mile radius looking for houses, some donated by homeowners like attorney Bryan Brice, who get a handsome tax write-off and satisfaction.

BRYAN BRICE: This is reuse and recycle and and hope in a way that is affording home ownership to lower- and middle-income families, and if you look at this whole neighborhood it’s just amazing what they’re doing here to rebuild this area. We’re glad to be a part of it.

FAW: But there is more here being rebuilt than houses. Once, this neighborhood was crime-infested.

MURRAY: Gang members were giving some problems to some of our first homeowners here, actually. This was gang territory.

FAW: Now the area is virtually crime-free.

MURRAY: That demonstrates that revitalization really does work.

FAW: Her Builders of Hope also refurbishes and rebuilds rental units. That restoration and the rebuilding of the houses is performed in part through a mentoring and training program established by Murray. Her organization hires hard-to-employ men who’ve had prison records or substance abuse problems, like the long-term alcoholic Kennie Byrum.

KENNIE BYNUM: I could see that they cared about not only just me, not focusing on let’s stop what we’re doing and care about Kennie, but let’s bring Kennie along and show him that he can be part of something that deals with caring about others. It’s a fellowship that I’ve never witnessed before or been part of before.

FAW: So lives are also being transformed here as well as houses. Phillip Brickle, once a longtime drug addict who became a pastor, now owns one of Nancy Murray’s houses.

PHILLIP BRICKLE: It’s a place of peace. It’s a place of joy.

FAW: What’s it do to someone like that? Do they change because they now can live in a home like this?

BRICKLE: I believe it gives an individual self-worth. You know, it also gives an individual a feeling of ownership, and any time you have a feeling of ownership it gives responsibility. So I do think it does bring about responsibility, and whenever you have more responsibility, it brings about change.

FAW: Juggling house moving schedules with city zoning permits, among other issues, is a true test of Nancy’s faith.

NANCY MURRAY: I would get mad at God, you know. It was like, okay, you brought me here, you convinced me to do this, you know, this project is about to fall apart. Everything is going to go by the wayside.

FAW: Finally, she says she put her fate in God’s hands to guide her to make the right decisions. It was then, she says, Builders of Hope took off.

MURRAY: You’re saying, okay, we’re here for a reason. Why are we here? What do I need to learn? What people are going to interface with me because we’re in the midst of this problem that maybe because I’ve met them something else is going to happen? So you trust that everything happens for a reason, and it’s all connected, and ultimately gets you to the place where God wants you to be.

FAW: In addition to the projects in North Carolina, Nancy’s Builders of Hope moved, refurbished, and relocated 76 homes in New Orleans that were about to be demolished to make room for a new hospital. It’s estimated about 250,000 houses a year in the United States get torn down. Cities like Detroit and Dallas have contacted Nancy about her work.

MURRAY: This is a model that can replicate, and then it does have very important ramifications, I think, nationally in terms of being able to rebuild neighborhoods and to get people back in housing, but we do need funding. We need supporters.

FAW: With the constant fundraising it is a struggle, but the satisfaction, she says, is worth all the uncertainty and aggravation.

MURRAY: You move them in over there, and the eyes and the excitement and the warmth and the pride—it’s just so sweet to see that when you do give them an opportunity and you give them a chance and something beautiful that they deserve, they take care of it and they blossom and they grow, and they really create a new community for themselves.

FAW: Here, where because of one woman’s faith a house is not just a home, it’s a new beginning.

For Religion & Ethics NewsWeekly, this is Bob Faw in Raleigh, North Carolina.

FRED DE SAM LAZARO, correspondent: The patients are often teenagers or barely in their twenties, yet several of them hobble in on walkers to physical therapy. These women suffer from fistulas, ruptures in vaginal, sometime even rectal tissue—a humiliating, even crippling consequence in most cases because of obstructed childbirth.

DR. CATHERINE HAMLIN: They’re leaking urine, and some of them are leaking bowel contents as well.

DE SAM LAZARO: Dr. Catherine Hamlin and her late husband, Reginald, came to Ethiopia in the 1960s as Christian missionaries and founded the Hamlin Fistula Hospital a few years later. A memorial to her husband invokes the Gospel of Matthew.

DR. HAMLIN: “Whatever you did for one of the least of these, my brothers, you did for me.” In the Bible it says my brothers, isn’t it? We say brothers and sisters.

DE SAM LAZARO: The least of the patients the young obstetricians saw were those with fistula. Amid a lot of suffering, Dr. Hamlin says the fistula patients were especially desperate.

DR. HAMLIN: She’s smelling. She’s poor. She’s got nothing, and she’s an outcast from her whole society, from everything that makes her happy. They lie in bed thinking if I keep really still, the urine will dry up. They curl up in bed. They become stiff. Their knees become contracted, their hips become contracted. They get nerve damage to their feet. The sciatic nerve is pressed on by the long labor, and they’ve got paralysis of the feet. They can’t bring the foot up.

DE SAM LAZARO: Fistulas were common across the world until the early 20th century, when prenatal care and modern systems of delivering health care, like cesarian sections, became available. Today fistulas are almost unheard of in richer countries, but two million women endure them in the developing world.

DR. YETNAYET ASFAW: For me as an Ethiopian, the fact that fistula is happening in the 21st century is not something that we are proud of.

DE SAM LAZARO: Dr. Yetnayet Asfaw works with a nongovernment aid group called Engender Health. She says the big issue is access to care in the vast, impoverished rural areas of this land of 82 million people plus myriad cultural practices.

DR. ASFAW: Eight-four percent live in the rural population, so the majority are rural women, and for rural women the issues are many. Women don’t have access to education. There are also several cultural issues, such as harmful traditional practices. Female genital mutilation is one, early marriage is another.

DE SAM LAZARO: Complications from the practice of cutting external female genitalia and other trauma, like rape, are thought to cause about 20 percent of fistulas. But the vast majority are a complication of obstructed labor, which results both in still birth and permanent injury to the young mother.

DR. HAMLIN: The pelvis of the woman is too small for the baby to come through, or the baby’s in a bad position inside the woman. So my husband used to say it’s either the passage or the passenger. The passage is the pelvis that it’s got to negotiate to get out, and the passenger is the baby, which if it’s not lying in the right position can cause the obstruction.

DE SAM LAZARO: Vaginal and rectal fistulas can be repaired surgically, and Dr. Hamlin, who is 87, still performs many of the procedures, like this woman’s case. We were asked not to use patient names.

DR. HAMLIN: Three days of labor, and then she had a stillborn baby, and then she was left with a vaginal fistula in her bladder. And it was quite—it was a reasonably difficult one.

DE SAM LAZARO: What’s the period of convalescence?

DR. HAMLIN: I think in about 10 or 12 days.

DE SAM LAZARO: She’s better off than most women here. Many have lived with their injuries for years, too late to be repaired even with surgery. Hospital services are free, but transportation is often unaffordable—if they can get a ride.

So how far away has this lady traveled to be here?

DR. HAMLIN: It’s about a four-hour drive.

DE SAM LAZARO: Four-hour drive, which for her would mean a bus ride, maybe?

HAMLIN: She would come in a bus, yes.

DE SAM LAZARO: Which sometimes is difficult for them, if they’re…

DR. HAMLIN: Yes, it is difficult, and sometimes the passengers say, “This woman’s smelling. Put her off. She’s got some disease,” and they’ll be thrown off the bus.

DE SAM LAZARO: To offer better access to its services, the Hamlin Hospital created five satellite facilities like this one in the rural countryside. They are funded entirely by donations from governments and private, often church-based donors. Still, only a third of the 10,000 Ethiopian women who develop fistulas every year receive any care for them. That’s why experts say it’s important to shift the focus from repairing fistulas to preventing them. Ethiopia’s minister of health, Dr. Tedros Ghebreyesus says a holistic approach is needed.

DR. TEDROS GHEBREYESUS (Ethiopian Minister of Health): We need to focus more on community-based interventions and on preventing the fistulas. The most important issues, it’s the education part, which will be very important, and also law enforcement, like age of marriage is very important. Girls’ education is very important, and we’re working on that.

DE SAM LAZARO: His ministry has won praise from public health experts for building a network of rural health centers in recent years, with a major focus on maternal and child health. But there’s still a huge shortage of skilled people to staff them.

Midwife students in class: Anterior, posterior ….

DE SAM LAZARO: A few years ago the Hamlin Hospital began a four-year midwifery program. These freshmen were studying plastic models of the female pelvis, learning how to detect abnormalities in the fetus position. So far two dozen graduates have gone on to staff regional health centers in rural areas—a small, promising start, says Dr. Hamlin.

DR. HAMLIN: We just have to keep the next generation of doctors and nurses inspired to help these women until it’s eradicated from the countryside, and it can be eradicated and it will be eradicated. In England, obstetric fistulas no longer occurred after 1920, so it’s not so very long ago that fistulas were occurring in England and in Europe.

DE SAM LAZARO: But Ethiopia, like so many developing countries, has a long way to go. Most Ethiopian women today still deliver their babies without the presence of a skilled birth attendant.

For Religion & Ethics NewsWeekly, his is Fred de Sam Lazaro in Addis Ababa, Ethiopia.