Step 1: Retain outsourced labor

Technique 1: Give your volunteers a reason for staying on board

Early in its existence, the foundation recognized that volunteers would be one of its strongest and most prominent resources. In order to develop attract a sturdy base of volunteers, the foundation began offering a series of trainings ranging from basic health to computer classes. The volunteers were more eager to remain committed to the foundation because they felt that they were receiving professional development; the majority has, in fact, been volunteering steadily with the organization for more than ten years. Known as "collaborators," the self-organized volunteer "troops" are deployed to public clinics and women's groups to discreetly transmit health information through informal talks and pamphlets.

Technique 2: Give responsibility to professionals and students

The foundation mobilized professionals and students to play a key role by making them responsible for critical pieces of the system. Social work students, who needed to have hands-on experience in order to graduate, were put in charge of tracking the patients throughout the system and analyzing the internal and external results. Meanwhile, professionals at the underutilized Professional Association of Obstetricians and Gynecologists provided both the physical space to receive patients and the technical know-how to gather the women's health data and send them to the appropriate doctors. The more involved the professionals and students became, the more committed they remained.

Step 2: Ensure that there are many levels of community support and income generation possibilities

Technique 1: Don't be afraid to engage peripheral players

In addition to volunteers, the foundation recognized that it needed both publicity and some capital to power its system. In an unlikely move, it began gathering together individual artisans who otherwise worked alone and had few places to sell their work outside of their personal workshops. Simultaneously, the foundation began brokering with the Worker's Cooperative, the majority stakeholder of the district's largest shopping mall, to provide a rent-free space for a collective of these artisans to sell their wares and promote the foundation's services.

Artists' collective storefront: "A Place"

Technique 2: Help others build a social enterprise that reinvests in your organization

Having brokered the contract, the foundation was able to turn over the store's ownership and management to this newly formed artisan cooperative. Lacking collective purpose or high-level connections, few artisans had previously imagined it possible to have a shared workspace, let alone one in a prominent rent-free storefront (saving US$14,300 per year) on the first floor of the mall. Given the unassuming name "A Place," the store houses the crafts of more than 20 local artists who publicize the foundation's work in the store and donate 15 percent of their profits to the foundation.

Another view of the storefront

Step 3: Create a professional system that makes it easy for local health care practitioners to extend their services to the most needy

Now that it had a base of citizens aligned behind its work, the foundation needed to create a quality health care delivery system. Using the capital provided by the artisans' store, the foundation has coordinated a decentralized system of local institutions and individuals to give women access to low-cost mammographies. From public clinics and hospitals, patients are sent to the Professional Association of Obstetrician and Gynecology, which serves as the professional and operational hub of the system. Once staff and graduate school interns collect patients' data, patients are directed to private radiology clinics that perform the mammography, charging only the at-cost price of the x-ray paper. Recovering this cost from patients ensures that they keep their appointments, allowing the radiologist's office to book their public and private patients during the same office hours, while guaranteeing all patients' anonymity.

Technique: Don't rely on good will alone

Instead of depending on charity alone to power this system, the foundation has made the partnerships rewarding for all players: the artists receive the financial and social support benefits of a commercial venue; the radiologists gain a new client base; the Worker's Cooperative better serves its members and improves their social image; the interns receive real, hands-on training; and the volunteers develop professional skills and witness tangible impact. And, most important, they all contribute to improving women's healthcare.

(i) Mobilizing Citizen Support: Community support is the catalyst of the program. Outreach through the store, media coverage, and group discussions achieve the buy-in of the community. This high involvement of community members reflects the trust that the foundation has carefully constructed among its citizens.

(ii) Generating Financial and Nonfinancial Resources: 15 percent of the store's revenue is donated to the foundation, representing 12.8 percent of the foundation's overall budget. Meanwhile, the use of volunteers and donated space (such as the Professional Association of Obstetrician and Gynecology and the Cooperative's offices) means that the foundation avoids paying for staff and office space, and pays negligible overhead costs.

(iv) Engaging and Managing Volunteers: Forty volunteers are organized in a thoroughly managed system. The volunteers are enticed by professional development trainings led by community partners. Volunteers remain committed because they authentically co-develop all programs. They are even designate as "collaborators" instead of "volunteers."

Since the system taps into preexisting institutions and local volunteerism, it does not require overhead capital for a physical space or staff. It is propelled by its own momentum, and engined by a sturdy base of trained volunteers and locally generated income.

According to an independent evaluation carried out by a local university in 2002, the foundation earns US$12,018.60 from the store's profits, which represents 62 percent of the total program's costs. Meanwhile, it received US$4526.40 in donations from the 60 percnet of its patients who give back to the foundation. The remaining costs are covered through local grants. Although most of the foundation's work is concentrated in the region, it has national impact — the data collected both before and after the mammography lends scientific credibility to the public's demand that the government fill this public health vacuum. They are intending to expand the program by involving more private medical specialists.