The Blue Sweater: Bridging the Gap Between Rich and Poor in an Interconnected World (35 page)

By early 2001, we had a business plan in hand and had raised more than $8 million, but hadn't yet named the organization. One of my favorite lines in literature is from a work by Tillie Olsen: "Better immersion than to live untouched ... Yet how will you sustain?" I'd considered naming the organization Immersion. After all, doing this kind of work would require using all parts of ourselves-our heads and our hearts. And we would need moral imagination to put ourselves in the shoes of other people. It would mean having the courage as well to fall down and get back up and try to make progress all over again.

Though most women were comfortable with the name Immersion, men's reactions were typically to reject it, thinking it sounded too soft and murky. So I invited a group of friends and colleagues to a "naming dinner" at the Rockefeller Foundation, where we generated a long list of names for this new entity that would bridge different worlds, all with a focus on smart, strategic, targeted philanthropy.

My brother Michael, with whom I'd been in conversation since childhood about how to change the world, worked on Wall Street. He matched my sincerity with an edgy humor, suggesting that the name should be something like "Ain't Your Grandma's Philanthropy." As the wine flowed, the names became sillier. By the end of the evening, our group had amassed more than 400 names, most implausible, all creative and full of life. Something in this new idea was capturing people's imagination. Finally, with the help of my friend Antonia, who worked with a fledgling Internet company, we decided on Acumen Fund, a label we hoped would signify thoughtful, insightful, smart, and focused change-precisely what we were after.

Next we had to obtain approval from the IRS as a nonprofit organization, no easy task in 2001 given that there was no exact precedent for what we wanted to do. We were completely agnostic as to whether change came through nonprofit or for-profit channels; in fact, we believed it would come through both and often in partnership. Thankfully, our lawyers were able to register Acumen Fund as a public charity on April 1, 2001.

Changing the lexicon was the next hurdle. Traditional charity speaks of donors and grantees, but this passive language creates a power dynamic that might as well call the two groups the givers and the takers. I had seen so many dysfunctional conversations where a grantee would give a wouldbe or existing donor misleading and evasive answers because they feared losing funding if they told the truth about the difficulties of their work. And I'd seen those same grantees agree to do things the donors thought they should, even if it made no sense for the mission of the organization. It is hard to say no to someone who has the power to finance your dreams-or more to the point, your payroll.

I also took issue with the practice of donors typically funding only programs instead of institutions. "I want to be certain that all of the money goes directly to the people who need it most," prospective donors would tell me. That is a fine strategy for providing alms or direct charity. At the same time, no one would invest in a company and not expect it to pay for hiring great people, paying the rent, and keeping the lights on. We needed philanthropists to build powerful institutions in the social sector, too.

We committed ourselves to changing the traditional donor-grantee relationship. Our donors would be called investors. They were still giving us charitable gifts, of course, but we wanted them to think of themselves as investing in change, of taking seriously how their money was spent. We wanted to build incentives for more honest conversations; in fact, we would ask for big gifts to help build a real organization and then promise to tell them about failures as well as successes. After all, as investors, they were betting on long-term results and should feel like owners who would go through the ups and downs with us, just as they would with a company. I would tell them, "You don't get any money back from your investment. You get change."

While we had the luxury of starting Acumen Fund with significant institutional funding, we felt it would also be critical to build a community of individual investors from the start, people who would commit not only money but also their time and connections to the work. We sought to enlist 20 "founding partners" who would establish the initial base of money, intellect, skills, and networks on which we would build our institution. I asked each person to contribute $100,000 despite the fact that we had no track record and a vision that many people didn't fully understand.

Finding the first 20 was, of course, much harder than we'd imagined. More than a few Wall Streeters explained that they kept a strict division between the way they made money and the way they gave it away.

"You are trying to do both at the same time, and it will never work. Businesses operate for profit alone, and that is how they make good decisions," an investment banker told me one summer afternoon. "Your idea of combining business and philanthropy not only won't work, it is misguided." Needless to say, he didn't contribute.

Others felt the whole idea of solving global problems made no sense given the challenges at home. One of a group of financial investors and scientific experts at a dinner asked me whether "AIDS might actually be a natural culling process.

"Maybe trying to stop it," the scientist remarked, "is ultimately detrimental to the long-term health of this planet that is already facing the negative consequences of high population growth." I spent an hour or so trying to convince the group not only of how immoral I found that idea, but also how self-defeating and counterproductive it was in a world where disease flows easily across national boundaries.

With practice, as the message became clearer, I could discern more quickly which individuals would help and which ones were more focused on finding excuses rather than working on solutions. I also relied on my good friends to make me laugh and keep the big picture in mind after too many days in a row of hearing nothing but "no, thanks, but good luck."

Ultimately, the money came, at least as much as we needed in the early years. It is only now that I realize the true debt of gratitude I owe to each of the early adopters of this innovation, those first 20 founding partners, along with the Rockefeller, Cisco, and W. K. Kellogg Foundations, for they took big bets on what may have seemed-at least to some-an unlikely dream, but one which, if brought to fruition, could actually contribute to changing the face of philanthropy.

With funding and legal status finally in place, we hired a team of three in April 2001, including Dan Toole, our first COO. I couldn't think of a person I trusted more to start this journey with me. He already had been a vital partner, helping me think through parts of the vision, and would be instrumental in our early stages of growth. I also hired David Buxbaum, a crusty investment banker, Rustom Masalawala from Silicon Valley's technology sector, and Nadege Joseph, who became my trusted assistant.

In one of our first team meetings, I asked how we would differentiate ourselves from other nonprofits in terms of the culture of Acumen Fund.

"This should be a place where nonperformers get fired," David offered, and everyone agreed. If we were to hire excellence, then people had to know we were serious, and that meant letting individuals go if they weren't up to our standards or, more often, if it turned out they weren't the right fit for the organization.

After her prestigious Wall Street career, Margo Alexander, the first woman to head a major trading floor, became our board chair. She fit our desired profile of being both tough and compassionate and always curious about the world. Along with the rest of the trustees, she would give more of herself to this start-up than she-and the others-had probably ever expected.

The biggest early challenge our new little team faced was finding the entrepreneurs and ideas in which to invest. We had decided to start in health technologies with a focus on India and East Africa. I assumed that with our connections to foundations and the United Nations we would have no problem identifying social entrepreneurs in whom we could invest. We were looking for ventures with visionary leaders who were using business approaches to solve big social problems. Their enterprises were to demonstrate the likelihood of financial sustainability and hold the promise of reaching a million customers over time. We figured that in an area like health care and a geography that encompassed more than a billion people, we'd have no problem identifying "pipeline opportunities."

We were wrong. We talked to countless people, asking for advice and connections. Many pointed to wonderful innovators who were working at the community level but didn't give us confidence their ideas would actually grow, or scale in our language of business. We hired two summer interns who spent long days surfing the Internet, trying to identify possible candidates. Ultimately, we reviewed more than 700 enterprises, and none fit our three criteria of leadership, sustainability, and scale in part because we limited ourselves to the nonprofit sector that first summer, where we had greater contacts.

By the end of the summer, we were in a bit of a panic, and a wise CEO of a health care company gave me advice I will never forget. "Just start," he said. "Don't wait for perfection. Just start and let the work teach you. No one expects you to get it right in the very beginning, and you'll learn more from your mistakes than you will from your early successes anyway. So stop worrying so much and just look at your best bets and go."

Still, I argued, our vision depended on finding the right social entrepreneurs.

"So find the best entrepreneur you know and start from there."

A leader who represented our ideal was Dr. Govindappa Venkataswamy, who founded the Aravind Eye Hospital in Madurai, India. When this extraordinary man retired in 1976 at age 58 from India's Civil Service as one of the country's most lauded eye surgeons, he decided to found an eye hospital to help rid the country and then the world of unnecessary blindness. Indians suffer blindness disproportionately because of the higher incidence of diabetes among both adults and children, a result most probably of genetics and diet. The fact that millions in India are blind did not intimidate Dr. V. from starting an 11-bed hospital in a simple house.

Today, Aravind Eye Care System examines more than 2.3 million patients a year, performing more than 280,000 cataract surgeries that restore sight to people regardless of their capacity to pay. Each doctor performs, on average, 80 surgeries a day. The US average, in comparison, is six. If ever there were a social entrepreneur who fused tough discipline with powerful compassion, it was Dr. Venkataswamy. We decided to meet with him and see what innovation he might be undertaking.

I met Dr. Venkataswamy on a hot afternoon in the tiny Madurai airport in the state of Tamil Nadu, in South India. He was about 80 then, and I'd heard he suffered from rheumatoid arthritis. What I hadn't expected was the spirited lightness of this fine-boned, white-haired man with leathered skin. As he stood, a baseball cap on his head, he clutched a wooden cane with his mangled hand and I saw that he'd adorned one finger with a gold ring above the knuckle. This detail, in combination with his broad smile, reminded me of John Gardner: Dr. Venkataswamy was also full of sparkle, a walking example of integrity, and he saw beauty everywhere.

"You didn't have to come and get me yourself," I laughed upon introducing myself.

"Why not?" he asked. "You are our guest and I am happy to know you."

Dr. V.-as he was usually called-surprised me again by getting behind the wheel to drive me to the guesthouse. He swerved in and out of the traffic like a teenager, beeping the horn at least 15 times per minute as he talked incessantly about his model for change. I listened with amazement, trying to soak in the scene, feeling a sense of openness just by being near him.

"We run Aravind like McDonald's," he explained, "clean and organized, with every process known and understood so that we get maximum efficiency. Two-thirds of the patients pay nothing or nearly nothing, and yet the hospital is consistently profitable-and growing."

"How do you do that?" I asked, focusing my eyes on him, trying not to be distracted by the animals and the trucks and the children running in the dusty streets.

"We have these systems that I was explaining to you," he said, "and we simply don't turn anyone away. You will see how it works."

First we drove to the organization's guesthouse on a quiet street a few blocks from the hospital. It was a pristine building with cool white marble floors, a small eating area, and individual rooms upstairs. Mine had a bed and a ceiling fan, a small closet, and its own tiny bathroom. Pictures of Sri Aurobindo, the spiritual leader Dr. Venkataswamy followed, hung on the wall. Everywhere you could feel a sense of quiet, respect, discipline, and grace.

The hospital itself was a lot busier, though a sense of groundedness and calm was pervasive. The 1,700 young women workers all wore saris in different colors, depending on the function they performed. I saw one doctor gently help a disheveled woman settle her sari more modestly on her frail, thin body. The pure grace in the doctor's interaction with the woman made me want to cry-this was the kind of compassionate care that is too often missing in US hospitals. For Dr. Venkataswamy, how you did things was as important as what you did, and he believed that great strength and spiritual fulfillment can come from the divine nature of work done well.

During the first year of Acumen Fund's existence, we looked specifically for health care technologies, thinking technology was a key driver of innovation for issues of poverty, an approach Dr. V. understood. For the first 30 years of Aravind's existence, the surgeons would simply remove patients' cataracts and give them thick glasses to enable them to see again. When the intraocular lens, which is inserted right into the patient's eye, was invented, Dr. V. knew this could revolutionize eye care. But the price, at about $140 in 1990, was prohibitive-and he'd learned that systems requiring the poor to wait for charity or government services would leave most of them waiting for a very long time.