Winners for the competition: 2003 Global DM: Services for the Poor

In India today, more than 200 million people suffer from blurry up-close vision, a condition clinically referred to as presbyopia. These people need reading glasses to work—to read a ledger, to thread a needle, to mend a shoe. They need them to live—to separate stones from rice for the evening meal, to read a religious text, or to enjoy the newspaper. In short, they need reading glasses to lead full and productive lives. The problem is that the cost of an eye exam is prohibitive for most Indians.

Wildlife such as elephants and buffalo often destroy crops in marginal farming areas where poor soils, erratic rainfall and plant disease already limit agricultural potential. Large fields are difficult to defend, and the types of crops that are grown are vulnerable to predators. The most common way of dealing with the problem is to hunt and kill the predatory animals before they strike. Farmers protect their crops with traditional methods, such as fire, catapults and beating drums to drive the animals away. But these methods do little to protect their farms from being destroyed.

Large social and economic programs, with large budgets, are able to bear the heavy costs of sharing assessment information with high-end technology. Smaller, lower-cost, community-based programs, on the other hand, cannot. They often forego the data-driven assessment process entirely, relying on less rigorous, qualitative measures of effectiveness. With increasing competition for limited funding, however, donors are demanding more sophisticated, data-driven assessments, and this leaves smaller, lower-cost programs—even potentially very effective ones—out in the cold.

The perceived conflict between development and conservation is a key issue in the Ha Tien Plain, a region that has seen its share of failed development projects. The acid soils of the Plain, in the southwest corner of Vietnam, support a mosaic of grassland, wetland and limestone ecosystems, which are being destroyed due to increased shrimp pond development and subsistence rice farming. The Khmer people live in poverty in the area—although they may work at the shrimp ponds they see little of the profit.

More than two-thirds of Turkey's citizens live in very high seismic risk zones. As is often the case, the poor are most susceptible to death in the wake of earthquakes, mainly because 45 percent of the population in Turkey's four largest cities live in houses that have not been engineered to withstand major seismic forces. From 1992 to 1999, earthquakes killed some 18,000 people. Existing masonry strengthening techniques to make house less vulnerable to earthquakes are unaffordable to poor people. An inexpensive solution is necessary to prevent more houses from collapsing in the future.

The WHO estimates that there will be eight million TB casualties by the year 2015, a 400 percent jump from current levels. In Tanzania, some 40 percent of TB-cases are HIV related. Nevertheless, it has been proven that if detected in an early stage, TB cases can be treated effectively, even in HIV positive patients. The WHO promotes the use of sputum smear microscopy as an affordable diagnostic method for the detection of TB in low income countries. But the analysis is slow, as qualified lab technicians can take a full day to analyze just 20 samples.

Much of the recent Western medical interest in traditional medicine has focused on extracting medicinal plants from the rainforests. However, little or no revenue from the sale of such pharmaceuticals ever returns back to the indigenous communities. In contrast, health initiatives that actively promote and foster safe traditional medical practices contribute directly to the immediate need of indigenous peoples' health. They also contribute toward the continued transmission of indigenous medical practices.

Fynbos is a shrub like vegetation indigenous to South Africa. Wild fynbos harvesting is a traditional activity of rural communities in the Cape Floristic Region of South Africa. Most of the rural communities working in fynbos harvesting are employed on a six months seasonal basis, usually with no contracts, low salaries and no benefits. Over-harvesting and ploughing native fynbos to cultivate commercially important species severely threatens lowland fynbos.

Two-thirds of South Africa's clinics are rural and less than half of those have an effective communications system in place. As a result of this lacking infrastructure, rural clinics are excluded from the South Africa Department of Health's "tele-health" program. There is a desperate need to create awareness about the causes of diseases that are preventable if only the communities were properly informed. A wireless network will help rural clinics provide improved healthcare to poor, rural communities at lower costs to patients than traditional healthcare service.

There is no health without mental health. Mental health is an integral part of one's overall health and quality of life. In a country ravaged by HIV/AIDS, the need for adequate mental healthcare is enormous and yet is tragically lacking. There are only 4.5 psychiatric beds per 10,000 people. In Australia, for the sake of comparison, there are 25 psychiatric beds per 10,000 people. As a result of South Africa's deficiency, many individuals are living without treatment, and are in many cases choosing suicide as a solution to what they see as a hopeless situation.