by David Brooks

NYT Op-ed

Nairobi, Kenya

Many Americans go to the developing world to serve others. A smaller percentage actually end up being useful. Those that do have often climbed a moral ladder. They start out with certain virtues but then develop more tenacious ones.

The first virtue they possess is courage, the willingness to go off to a strange place. For example, Blair Miller was a student at the University of Virginia who decided she wanted to teach abroad. She Googled “teach abroad” and found a woman who had been teaching English in a remote town in South Korea and was looking for a replacement.

Miller soon found herself on a plane and eventually at a small airport in southern South Korea. There was no one there to greet her. Eventually, the airport closed and no one came to pick her up. A monk was the only other person around and eventually he, too, left and Miller was alone.

Finally, a van with two men rolled in and scooped her up. After a few months of struggle, she had a fantastic year at a Korean fishing village, the only Westerner for miles and miles. Now she travels around Kenya, Pakistan and India for the Acumen Fund, a sort of venture capital fund that invests in socially productive enterprises, like affordable housing and ambulance services.

The second virtue they develop is deference, the willingness to listen and learn from the moral and intellectual storehouses of the people you are trying to help.

Rye Barcott was a student at the University of North Carolina who spent a summer sharing a 10-by-10 shack in Kibera, the largest slum in Nairobi, Kenya. One night he awoke with diarrhea and stumbled to the public outhouse. He slid onto the cement floor and vomited as his bare body hit puddles of human waste.

He left his soiled pants outside the hut, but when he went to find them later they were gone. He was directed to another hut where a stick-thin girl, with missing clumps of hair, had the pants, scrubbed and folded, in her lap. Barcott said softly, “I’m grateful,” and asked her why she had cleaned them. “Because I can,” she replied. A week later, she died of AIDS and her body was taken in a wheelbarrow to a communal grave.

Over the next several years, Barcott served as an officer in the Marines in places like Iraq and created an inspiring organization called Carolina for Kibera, which offers health services and serves as a sort of boys and girls club for children in the slum.

The greatest and most essential virtue is thanklessness, the ability to keep serving even when there are no evident rewards — no fame, no admiration, no gratitude.

Stephen Letchford is a doctor working in Kijabe, Kenya. One night, years ago, when he was working at a hospital in Zambia, a man stole a colleague’s computer. Letchford drove the police down the single road leading from town. The police found the man carrying the computer and, in the course of the arrest, shot him in the abdomen.

They put the man in the back of the car and rushed him back to the hospital to save his life. Letchford pressed his wounds to stem the bleeding, using tattered garbage bags as surgical gloves. He had scraped his hands gardening that day and was now covered by the man’s blood.

They saved the thief’s life and discovered he was infected with H.I.V. For several days, Letchford and his family were not sure whether he had been infected by the man who robbed them. Their faith was tested. (They later learned that he was not infected.) When the man recovered, he showed no remorse, no gratitude; he just folded in on himself, cold and uncommunicative.

This final virtue is what makes service in the developing world not just an adventure, a spiritual experience or a cinematic moment. It represents a noncontingent commitment to a specific place and purpose.

As you talk to people involved in the foreign aid business — on the giving and the receiving ends — you are struck by how much disillusionment there is.

Very few nongovernmental organizations or multilateral efforts do good, many Kenyans say. They come and go, spending largely on themselves, creating dependency not growth. The government-to-government aid workers spend time at summit meetings negotiating protocols with each other.

But in odd places, away from the fashionableness, one does find people willing to embrace the perspectives and do the jobs the locals define — in businesses, where Westerners are providing advice about boring things like accounting; in hospitals where doctors, among many aggravations, try to listen to the symptoms the patients describe.

Susan Albright, a nurse working with disabled children in Kijabe, says, “Everything I’ve ever learned I put to use here.” Her husband, Leland Albright, a prominent neurosurgeon, says simply, “This is where God wants us to be.”

Bill Frist: NPR Interview with Melissa Block

To listen, CLICK HERE.

Former Senator Bill Frist just came back from a fact finding-finding mission to the border of Kenya and Somalia. He and Jill Biden, the vice president's wife, visited the Dadaab camp, which was designed for 90,000 but its population of Somalian refugees has swollen to 430,000.

In an interview with NPR's Melissa Block, Frist threw out numbers. Lots of them that put the situation in the Horn of Africa in some perspective. He said: This is the worst drought in 60 years; 29,000 children under the age of five have died in the past 90 days; tens of thousands are dead; 12 million people are at risk of death; 42 percent of them die from starvation.

All of that is hard to visualize, but then Frist talks about the people he talked to at the camp.

"A family might be typically a woman who has four children, who has walked for 15, as many as 20 days to leave the area of famine and lawlessness and lack of aid... and walk across a desert, arriving many times missing one child, a child who died along the way," he said.

The children arrive at the camp malnourished or starving and what's amazing, he said, is that an inexpensive mix of water, sugar and nutrients will bring a child back to life.

Frist has seen human tragedy. He's been to Rwanda during the genocide and saw the 1980 famine in the horn of Africa. He's been to Chad, Darfur and Sudan but he says what strikes him about this particular crisis is that "the world is responding to the need itself but the need is increasing faster than the response."

"The simplicity with which this can be addressed... is not keeping up with increased demand," he said. "They're all human tragedies, but this one we can nip in the bud if we're more aggressive."

Melissa also asked some tough questions of Frist, the chairman of the non-profit Hope Though Healing Hands. She brought up the AP report that detailed that thousands of sacks of food aid were being stolen and asked what he would tell Americans, struggling through a bad economy.

"We spend less than half a percent of our budget on all of developmental aid. Not just responding to crisis but in all of developmental aid. So we don't spend nearly as much as people think," he said.

Frist admitted that this famine is a man-made crisis. The drought is bad but the political situation on the ground, the fact that Islamist militant group al Shabaab has not let aid flow in has made things worse.

"But it doesn't mean we give up," he said. "It means we stay on it. We do the best we can as the oneness of humanity gets translated by [non governmental organizations], by partnerships, by governments, by individuals who focus on it."

To read more, CLICK HERE.

CRISIS IN THE HORN OF AFRICA - Dr. Bill Frist, former Senate majority leader, telephoned Playbook after returning from a trip with Dr. Jill Biden to a famine refugee camp on the Kenya-Somalia border: "The Horn of Africa is undergoing the most acute food-security emergency in the last 25 years - 29,000 kids have died in the last 90 days. The response to the crisis is improving globally, but the magnitude is outstripped the supplies. ... Two issues that I'm stressing: Number one, lives can be saved by both individual Americans, and taxpayers through our government responding and investing. And, number two, our long-term investments over the last 10 years, through the USAID, in the Horn of Africa, have paid off. ... "Dr. Biden is very effective in listening, observing, listening, asking questions, and representing the United States in terms of concern and commitment of support. Because she's not in the political hotbed, for me, who's out of politics, she was a perfect leader for the delegation. ... I have visited refugee camps in Chad and Darfur ... The striking difference here is the lack of access in Somalia, because of a dysfunctional government. There's no access to the millions of people in Somalia, where the famine is worst. Therefore, the refugees all have to go to Ethiopia and Kenya, where there is economic stress and environmental stress. ... The crowding in the refugee camps has resulted in pneumonia and a very rare skin disorder, ictchyosis. The kids are dying of pneumonia and diarrheal diseases. ... Individuals who do want to invest, the easiest place to go is USAID.gov, which has a list of nongovernment organizations."

Editor's Note: William Frist, the former Republican majority leader of the U.S. Senate, is a physician. 

(CNN) -- Why should Americans care about the unfolding crisis in Somalia when our own economy is in chaos? 

To shed some light on that question, I joined Dr. Jill Biden, wife of Vice President Joe Biden, on a fact-finding mission over the past several days to a Somali refugee camp close to the Kenya-Somalia border. 

We saw the answer as we listened to a grief-stricken mother of five, who had marched for 15 days across the parched Somali land to find food and security in a border camp. They arrived malnourished, sick and thirsty to a camp of 430,000 other refugees. They competed with 1,500 others who had made it to the camp that day, only to find it filled to capacity. Inside they would find adequate food and water. 

They would find the vaccinations that are saving the lives of thousands. They would survive because of the generosity of Americans (the U.S. is responsible for 47% of the food being provided) and increasingly because of members of the world community who are standing up, in spite of challenging times in their own communities. 

More than 29,000 children have died over the past three months in what is the most acute food security emergency on Earth. It's worsening by the minute and outstripping available supplies. Thousands never make it to the camps, and those that do might have to wait outside the confines where 50,000 others are waiting. 

Drawing from my experiences as a doctor in refugee camps in southern Sudan and Darfur, the conditions Biden and I saw this week constitute among the worst, the result of a cruel nexus of war, drought and poverty. The issue is complex, but we know with certainty that a primary focus on health greatly improves the chances of preventing death and of establishing security throughout the Horn of Africa. It's a worthy investment.

Drought occurs regularly throughout the region, but a dysfunctional government in Somalia is incapable of responding. Direct access by the international aid community is difficult and dangerous. This is why our focus on assistance in Ethiopia and Kenya is essential.

The five regions of famine in Somalia lead to death locally and to an exodus of children and families to Kenya and Ethiopia for food. The arrival each day of 1,400 to 2,000 new Somali refugees to the Dadaab Camp alone places a huge food, economic and environmental stress on eastern Kenya.

The good news for the American taxpayer is that investments by our humanitarian and development organizations have worked. Through past advances in agriculture and food security led by the United States, we learned that from the more plentiful regions of Kenya, food is flowing to the areas of greatest need. Even though tens of thousands have died in recent weeks because of the famine, I am certain that the number would have been much higher if the American people had not so smartly invested over the past decade. 

Drought and famine are not new to the Horn of Africa. By examining past famines, we have learned that among the most important acute interventions is taking steps to improve health. This primacy of health is not generally recognized by the public, but it is by USAID administrator Rajiv Shah, who accompanied us. 

Drought leads to famine, and famine leads to deteriorating health. Therapeutic health intervention with vaccines and oral rehydration is easy and cheap. But we have to get material to the region. And that is why the increased aid of $105 million announced Monday by our government is so important. This also shows that we can make such a difference as individuals through our own contributions (see http://www.usaid.gov/ for organizations). 

The region is witnessing the worst drought in 60 years with more than 12 million people in need of outside assistance. Even though contributions by government, NGOs and the international community are growing, the needs are growing faster than the world is responding.

Will the American people respond in these difficult times? I know based on my experiences in southern Sudan, Darfur, Chad, Haiti and Bangladesh that the American people will give generously and support our nation's ongoing response.

Americans are at their best when they respond unselfishly to others in need -- and they do so generously when they know that their investments, both personal gifts and government contributions, have value in saving lives in the short-term and supporting prevention in the long-term.

They know that their help will make a difference. Americans will act as they always do to help those in need.

The opinions expressed in this commentary are solely those of William Frist.