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Providing Relief In Dangerous Places

Because people in war zones shouldn't have to wait for humanitarian aid, Refugee Relief International, Inc. doesn’t wait for the fighting to stop. Its teams of combat-trained doctors, nurses and medics provide medical assistance and training in countries ravaged by war, ethnic cleansing and dictatorship when conventional humanitarian relief organizations won’t. And this charity is different in another way: With your donation, you can tell it where to help next.

Refugee Relief International (RRI) was founded in 1982 to provide medical care and training in active combat areas. “Our goal is not to duplicate the efforts of the main established charities,” says Dr. David Mohler, president of RRI. “Our goal is to optimize what we do that is unique. That is [to enter] guerilla warfare areas where you have to walk in or sneak in with your medical supplies on your back and you’re operating in hostile or denied territory.” The organization has sent teams to numerous countries, including Afghanistan and Iraq. Teams are made up of four to six medic volunteers, all with Special Forces military training.

RRI consists of an eight-person board of directors, about 40 combat-experienced medical volunteers and hundreds of other volunteers. The board includes members of the military, doctors and lawyers. Board members, including Dr. Mohler, also participate in missions and do not receive compensation from RRI.

The board must approve all requests for assistance. Mission proposals can come from several sources, including RRI members, refugee groups, government agencies and private donors. The board considers several criteria when evaluating a proposal, including how badly its services are needed, what the mission will cost, whether there are other organizations already providing relief, the risks involved for RRI volunteers, the availability of qualified personnel and whether the characteristics and goals of the targeted population are consistent with those of American citizens. RRI’s board also considers whether the mission may have to be repeated, or will aid in building infrastructure to the point of making additional missions unnecessary.

According to Dr. Mohler, a typical relief mission has several goals. “We provide training and direct medical care to the indigenous population that’s trying to resist whoever the bad guys are, and do it in a way that gets us in and out alive but allows us to be effective while we’re there. Most importantly, we leave behind upgraded medical skills and whatever supplies we can to the people who are going to continue on in that arena.” Classes held during missions consist of 20 to 30 students.

Dr. Mohler tells of training ethnic Karen refugees 12 years ago for three weeks along the Thai-Burma border. Two years ago, he says, he ran into one of his students, now a chief surgeon of a medical clinic on the border that treats thousands of patients annually for free.

Such success comes at considerable risk — the missions can be very dangerous. “Every place, with one exception, that we’ve ever set up to do surgery, feed patients or train people has been overrun and destroyed, anywhere from two weeks to 15 minutes after we left,” Dr. Mohler says.

A typical mission continuously tests volunteers’ medical knowledge. Upon arrival, team members travel to a medical facility, or prepare their own. Working with local doctors, they perform three to 10 operations each day, usually without running water or electricity. The procedures range from simple surgeries to the more complex, such as amputating limbs and treating victims of land mines. Volunteers are cross-trained in dentistry as well.

RRI’s philosophy of care is that quality is more important than quantity. The organization does not keep statistics on the number of people it helps. As Dr. Mohler says, there’s not much benefit to providing “vitamins and a toothbrush after a 30-second exam. It makes for great numbers, but amounts to not much medical care and a lot of resentment from people who stood in line for six to10 hours.” RRI volunteers try to assist as many people as they can, while emphasizing the quality of their interactions with patients and caring for those who need it most.

RRI volunteers assist around the globe. In addition to the recent missions in Iraq and Afghanistan, RRI annually helps groups targeted for ethnic cleansing by the Burmese military dictatorship. RRI has assisted Khmer Rouge defectors in Cambodia and sent medical personnel and supplies to a hospital serving the Miskitu Indians in the Bluefields Lagoon area of Nicaragua. RRI has aided refugees in Honduras and El Salvador, as well as victims of the Rwandan civil war.

RRI volunteers realize that they are not representing just their organization, but all Americans. They hope to be a positive influence on those who might otherwise be drawn toward extremist religious or terrorist groups. Instead of Americans being viewed as a nameless, faceless people, RRI hopes to show their caring and generous side. Dr. Mohler says he has never encountered resentment from those he was trying to help. “Because where we go tends to be extremely remote, it is not uncommon that we’re the only Americans anyone has ever seen, other than on al-Jazeera. Without exception, we have been welcomed and protected everywhere we’ve gone.”

If you are a potential donor, RRI’s “Missions to Order” program guarantees that your contributions will be used to aid the country of your choice. The venture capital firms in Silicon Valley, where RRI has its headquarters, served as models for this program. Here’s how it works: A donor can tell RRI that he or she has a mission in mind for a certain country. The donor may have an amount in mind, or RRI can provide a quote for the mission. “If they tell me what the mission is and how much money they have,” Dr. Mohler says, “we can figure out what we can do for that amount.”

RRI has performed just such missions to Burma and Afghanistan. In the latter, a donor wished his contribution to go to feed the people of Afghanistan, and had a certain amount he wished to give. Fortunately, RRI was already in the final stages of preparing for a mission to that country. The costs of supplies and transportation had already been paid with other contributions, so the volunteers were able to spend all of the donor’s check on food for the Afghan people.

RRI is able to make relatively small donations go a long way. According to RRI’s Web site, $5,000 sends a three-man surgical team anywhere in the world for two weeks; $500 pays for shipping a year's worth of medical supplies to a clinic in Central America; and $10 provides intravenous rehydration for five children stricken with cholera. In addition to cash, RRI also accepts contributions in the form of securities, plane tickets, frequent flier miles and medical supplies. And the organization is always on the lookout for new volunteers.

RRI attempts to keep operating expenses as low as possible so that donors receive maximum value for their contributions. In 2001, for example, 95.5 percent of expenses were for program services – missions. In 2002, however, to qualify for federal employee donations and federal grants, RRI hired an accounting firm for a full audit of its 2001 fiscal year and for tax preparation. This reduced to 56 percent the expenses related to program services. While Dr. Mohler acknowledges that the administrative expense is large, he says he hopes to receive government contributions of at least twice the amount, and that if the donations do not come in as expected, RRI probably will not continue to seek them.

Palisades Hudson Charitable Portfolio, Inc. (PHCP) has selected Refugee Relief International as one of the prospective charities to include in its Humanitarian Relief Fund, as part of the fund’s priority objective to alleviate human suffering caused by war, civil strife, famine, drought or natural disaster, and to restore infrastructure for normal economic activity. You can read more about PHCP at www.palisadeshudson.com and about the Arts & Culture Fund in the 2003-2004 Charitable Giving Program, also available at our Web site.

Managing Vice President Paul Jacobs, of our Atlanta office, is among the authors of our firm’s recently updated book, Looking Ahead: Life, Family, Wealth and Business After 55. He wrote Chapter 12, "Retirement Plans"; Chapter 15, "Investment Approaches And Philosophy"; and Chapter 19, "A Second Act: Starting A New Venture." He also contributed to the firm’s book The High Achiever’s Guide To Wealth.