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Charles Dickens originally released his literary classic A Tale of Two Cities in weekly installments in the 1850’s. In this vein, join me on a voyage, in monthly installments, to two fictional cities, Assetsville and Needsville—both poor communities in Africa.
I doubt any two topics are creating more news in our country right now than healthcare and job creation. And rightly so—they are important issues. In both Assetsville and Needsville, healthcare and job creation are also major issues. Easily-treated illnesses like malaria and diarrhea have wreaked havoc on families in these cities. Even buying medicine is a lethal guessing game. Job creation is a related and serious issue. In both cities, millions are unemployed and nearly everyone is underemployed. These cities feature identical problems, yet remarkably different approaches to addressing these issues.
In Assetsville, churches, charities and government assistance are focused, as you might imagine, on building on the existing resources and strengths of the community. As a result, hopefulness, respect, and mutuality line the streets. In Needsville, the same types of groups are focused not on the assets, but on issues, weaknesses and problem-solving. As a result, these groups collectively form a proverbial toolbox designed to repair Needsville’s problems. Sadly, this approach has driven out entrepreneurialism, community initiative, and even self-worth. Because of these differences in values, Needsville and Assetsville are worlds apart in their approaches to healthcare and job creation.
Needsville worked with various government agencies to establish foreign-run health clinics to address these serious problems. These clinics are facing insatiable demand for their services. The city also hosts teams of medical volunteers which come to treat common illnesses, conduct surgeries and bring in as much medicine as they can carry. These groups make a huge difference, but come sporadically. With these initiatives, incentives to provide good service are lacking, resulting in dim prospects of long-term viable health solutions in Needsville. In regards to jobs, healthcare is provided almost exclusively to the people of the community, but is not provided by the people of the community.
In Assetsville, however, a different story unfolds. Many new initiatives bring hope that quality healthcare and real job creation are not pipe dreams. A locally-run microfinance institution recently partnered with an innovative healthcare provider to provide loans to nurses interested in business ownership. These nurses  buy franchises from the healthcare provider, receive training and purchase start-up medical kits (shoulder bags complete with malaria tests, a thermometer, medicines and supplies), which enables them to treat 70% of common illnesses. They do not work out of a facility. Rather, these nurses travel to their neighbor’s homes and bring quality healthcare to the people.

Another fresh organization uses a similar solution for vision problems. Aspiring entrepreneurs are trained to diagnose and fit eyeglasses and thousands of Assetsville residents are now working more effectively, learning to read, and seeing the world in a whole new way. In the center of the city, aspiring business owners opened several new pharmacies, providing legitimate medicine and health supplies to those living downtown. Entrepreneurship, employment, and the engine of business, are driving innovation and quality healthcare service.
Two similar cities. Two vastly different prospects for the future of healthcare and job creation. But these cities have issues beyond healthcare. What about education? Food? Clean water? Financial services? Future installments will examine these issues at greater depth.