International Development Groups Now Starting to Help Poor in US

ACROSS the United States, international development organizations that have traditionally focused on the third world are discovering a sad truth: that more Americans than ever need their help, too.

Some groups, like Oxfam America, are launching their first US programs. Others, like Accion International, a group that promotes microenterprise, are branching into urban US work after several years in rural America.

Some of the granddaddies of international development that have had US components for decades, like the Christian Children's Fund - or even started as solely US programs, like Save the Children - are beefing up their domestic work after years of widening income disparity that have left the poor poorer. Worldvision heightened its US commitment in the mid-1980s.

Instead of "America first," call it "America, too."

Officials from development groups insist that their new or expanded US work will not divert resources from their third-world efforts. In fact, they hope that paying more attention to their own backyard will attract more interest and donations for all their programs.

"This is a very hot area for our members," says Tony Gambino of Interaction, an umbrella organization for 130 nonprofit development groups. At a recent Interaction conference, a panel focused on "reverse technology transfer" - third-world techniques in low-tech health care, small-scale business start-up, and community organization that groups are now applying to their work with poor Americans.

John Hammock, executive director of Oxfam America, says the impetus for starting a US program came, ironically, from the third world. When people there would discover that Oxfam has no US programs, he would hear: "Are you being paternalistic? Are you coming out to solve the problems of the world, when in fact your own world is not doing very well?"

"After a while," Dr. Hammock says, "you hear that several times, you start thinking."

Now, 22 years after its founding, Oxfam America feels it can contribute at home. Though thousands of groups are already working on hunger in the US, most of them through soup kitchens, Hammock sees a need to focus on helping people help themselves.

He cites successes in Bangladesh. In one village, Oxfam provided seed money to a group of women who started a profitable rice-husking mill. Nearby, Oxfam gave women materials to help them start a successful farm.

The lesson that's transferable, says Hammock, is that by going to existing community groups, Oxfam can offer its resources and expertise to make ideas reality. Oxfam's US program, not yet announced, will focus on rural America, he says. But Oxfam won't just go to the obvious places, like Appalachia and native- American reservations. Hammock wants to do work in Wisconsin "and other places that are not normally thought of as poor."

Another group with long international experience that has gone domestic is Accion International, which lends seed money to small-scale entrepreneurs. Accion has worked in Latin America 30 years, and in 1987 expanded to rural Arizona and California. Last year, it started operating in the Williamsburg section of Brooklyn, N.Y. "This has really caught on in the last two to three years in the States," says director William Burrus. "We get a call a day."

At Save the Children, heightened attention to American children has spawned a number of new urban programs in the past year in cities such as Dallas, Baltimore, and New Haven and Bridgeport, Conn. The focus is on day care, health care, and housing. In Baltimore, one program is devoted to boosting self-esteem among black males.

Save the Children, in conjunction with the Columbia, Md.-based International Child Health Foundation, is bringing oral-rehydration therapy - a simple method physicians say they use to battle childhood diarrhea successfully in the developing world - to low-income women in America. "Just as women in countries like Costa Rica and Cambodia have been taught to weigh their babies and administer the therapy themselves, so can poor mothers in Bridgeport and New Haven do the same," says Mary Hughes, director of U S programs for Save the Children.

In the medical field, reverse-technology transfer has its most obvious applications, sources say. American medicine has become so oriented toward high technology (and therefore expensive) that simpler methods are being bypassed and many people are doing without health care.

ONE Virginia-based group, INMED, is working at the request of the National Commission to Prevent Infant Mortality on a program to teach lay women how to work with others to prevent premature and low-birthweight babies. The lesson, which INMED learned in its foreign work, is to work at the community level and to learn how to use the system, says INMED's president, Dr. Linda Pfeiffer.

Another variant of "America, too" in medicine is at Yale Medical School. Residents in the international program who go to the third world for a stint are now also getting similar experience working with limited resources among the poor of New Haven.

A notable exception to the trend is CARE. "Every couple of years, we think about it [starting a US program] and we reject it," says communications officer John Mohrbacher. The justification: "There is more of a safety net in the US."